From schurc@chmc.org Sun Mar 25 11:41:56 2001 Received: from mxu2.u.washington.edu (mxu2.u.washington.edu [140.142.32.9]) by lists.u.washington.edu (8.9.3+UW00.05/8.9.3+UW00.12) with ESMTP id LAA58088 for ; Sun, 25 Mar 2001 11:41:55 -0800 Received: from zardoz.chmc.org (zardoz.chmc.org [146.79.130.11]) by mxu2.u.washington.edu (8.11.2+UW01.01/8.11.2+UW01.03) with ESMTP id f2PJfsM24041 for ; Sun, 25 Mar 2001 11:41:54 -0800 Received: (from uucp@localhost) by zardoz.chmc.org (8.8.7/8.8.7) id LAA17733 for ; Sun, 25 Mar 2001 11:42:26 -0800 Received: from (s102.chmc.org [146.79.130.7]) by zardoz via smap (V2.1) id xma017721; Sun, 25 Mar 01 11:41:48 -0800 Received: by s102.chmc.org with Internet Mail Service (5.5.2650.21) id ; Sun, 25 Mar 2001 11:41:20 -0800 Message-ID: From: "Churchill, Shervin" To: "'Washington public health assessment coordinators'" Subject: FW: MCH Alert Date: Sun, 25 Mar 2001 11:41:03 -0800 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2650.21) Content-Type: text/plain; charset="iso-8859-1" > -----Original Message----- > From: Sety, Megan > Sent: Friday, March 23, 2001 12:49 PM > Subject: FW: MCH Alert > interesting articles below > ************************************** > Megan Sety > Center for Children with Special Needs and Chronic Health Conditions > Children's Hospital and Regional Medical Center > PO Box 5371/CM-09 > Seattle, WA 98105 > (206) 527-5709, ext. 1 > msety@chmc.org > fax: (206) 527-5705 > > -----Original Message----- > From: MCH Alert [SMTP:MCHalert@list.ncemch.org] > Sent: Friday, March 23, 2001 8:25 AM > To: mchalert@list.ncemch.org > Subject: MCH Alert > > ************************************************************ > MCH Alert > Tomorrow's Policy Today > ************************************************************ > > National Center for Education in Maternal and Child Health > http://www.ncemch.org/alert > > March 23, 2001 > > 1. Homicide is the Leading Cause of Death Among Pregnant and Recently > Pregnant Women, According to Study > 2. Many States Do Not Give Children Legal Entitlement to SCHIP Coverage, > Claims Report > 3. Report Presents Trends Among Hispanic Children, Adolescents, and > Families > 4. Study Reviews Evaluation of Medicaid Managed Care Programs for Children > > ************************************************************ > > Readers: The Centers for Disease Control and Prevention (CDC) recently > released the first National Report on Human Exposure to Environmental > Chemicals. The report presents information on the U.S. population's > exposure levels to 27 environmental chemicals. The report indicates that > blood lead levels and levels of exposure to environmental tobacco smoke > have declined; it also presents other findings. Data were collected from > the CDC's National Health and Nutrition Examination Survey. The full > report is available at . > > ************************************************************ > > 1. HOMICIDE IS THE LEADING CAUSE OF DEATH AMONG PREGNANT AND RECENTLY > PREGNANT WOMEN, ACCORDING TO STUDY > > Homicide is the primary cause of pregnancy-associated death in the United > States, reports a study published in the March 21 issue of the Journal of > the American Medical Association. The authors of the study define > pregnancy-associated death as "death from any cause during pregnancy or > within 1 calendar year of delivery or pregnancy termination, regardless of > the duration or anatomical site of the pregnancy." > > The authors reviewed 247 death certificates of reproductive-age women, > live birth and fetal death records, and medical examiner records in > Maryland from 1993 to 1998 to determine the number and causes of > pregnancy-associated deaths. > > The authors found that > > * 73.7% of the pregnancy-associated deaths identified followed a live > birth; > * The leading cause of pregnancy-associated death was homicide, which > accounted for 20.2% of the cases; and > * 94% of the identified homicide deaths occurred during pregnancy or > during the 43- to 365-day period following delivery or termination of > pregnancy. > > The authors suggest that "maternal mortality review committees should > investigate homicide during pregnancy and in the postpartum period to > determine the relationship between the events." They conclude that > "enhanced surveillance of pregnancy-associated deaths is necessary to > accurately document the magnitude of pregnancy mortality, identify groups > at increased risk of death, review factors leading to death, and plan > prevention strategies." > > Horon IL, Cheng D. 2001. Enhanced surveillance for pregnancy-associated > mortality--Maryland, 1993-1998. Journal of the American Medical > Association 285(11):1455-1459. > > ************************************************************ > > 2. MANY STATES DO NOT GIVE CHILDREN LEGAL ENTITLEMENT TO SCHIP COVERAGE, > CLAIMS REPORT > > States that implement "separate" State Children's Health Insurance > programs (SCHIPs) (i.e., programs that operate under the separate > statutory authority of the federal SCHIP statute rather than as part of an > expanded Medicaid plan) tend not to confer upon eligible children the > legal right to health care coverage under state law, claims a report > published recently by the Center for Health Services Research and Policy > at The George Washington University. > > According to the authors, under SCHIP, a state may use its federal > allotment to expand Medicaid, thereby extending to eligible children the > legal entitlement to health insurance coverage. A state may instead elect > to establish its own separate SCHIP program that is not required to confer > the right to health care coverage to SCHIP-eligible children. > > The authors found that > > * 33 states operated their separate SCHIPs pursuant to separately enacted > state legislation (enabling legislation and/or appropriations > legislation); > * Among the 33 states, none of the separate program laws created an > individual entitlement of coverage for eligible children; > * Among the 33 states, 9 had laws that could be characterized as > restricting rights to coverage; and > * Among the 33 states, 24 had legislation that either expressly or by > implication refutes any inference regarding the existence of any > individual legal entitlement to coverage. > > The authors conclude that "this analysis indicates that if low-income > children are to be guaranteed health coverage as a matter of law, such an > entitlement necessarily would flow from the existence of a mandatory > open-ended federal entitlement rather than from separate state decisions. > The findings here suggest that the decision to create a right to health > care coverage must flow from a national commitment to do so." > > Rosenbaum S, Smith B. 2001. Policy Brief #1: State SCHIP Design and the > Right to Coverage. Washington, DC: The George Washington University, > Center for Health Services Research and Policy. Report available at > . > > ************************************************************ > > 3. REPORT PRESENTS TRENDS AMONG HISPANIC CHILDREN, ADOLESCENTS, AND > FAMILIES > > Hispanics are more likely than blacks or whites to give birth while > unmarried, commit suicide during adolescence, or lack health insurance, > but Hispanic women are less likely than black or white women to give birth > to a low-birthweight infant or to smoke during pregnancy, according to a > report released recently by Child Trends. The report summarizes key data > on Hispanics. > > The report highlights data on 1) education and work-force preparation, 2) > adolescent risk-taking, 3) family structure, 4) health and safety, and 5) > poverty. > > The report's findings include the following: > > * From 1991 to 1997, Hispanic students reported a lower rate of condom use > during last sexual intercourse, compared with black or white students; > * In 1996, Hispanics ages 15 to 19 had a higher birth rate than blacks or > whites in this age group; > * Since 1990, Hispanic women have had the highest nonmarital birth rate of > all racial and ethnic groups in the United States; > * Hispanics ages 15 to 19 are more likely to consider or attempt suicide > than blacks or whites in this age group; > * Hispanic children are less likely to have health insurance than either > black or white children; > * In 1998, a lower percentage of Hispanic women smoked during pregnancy, > compared with black or white women; and > * In 1998, a lower percentage of Hispanic women gave birth to > low-birthweight infants, compared with black or white women. > > The data were released in response to preliminary Census Bureau figures > indicating that Hispanics now rival African Americans as the nation's > largest racial minority. > > Child Trends. 2001. Trends Among Hispanic Children, Youth and Families. > Available at . > > ************************************************************ > > 4. STUDY REVIEWS EVALUATION OF MEDICAID MANAGED CARE PROGRAMS FOR CHILDREN > > > Researchers should concentrate on identifying appropriate data sources and > on selecting quality measures when evaluating Medicaid managed care > programs for children, according to the authors of a study published in > the March/April issue of Ambulatory Pediatrics. The authors outline > approaches to evaluating Medicaid managed care programs and focus on > issues such as identifying appropriate data sources, defining the Medicaid > population, and determining quality measures. > > The authors point out that it may be appropriate to review enrollment > files, provider files, pharmacy files, and health encounter files to > identify data sources. They also note that--when defining the Medicaid > population--researchers should consider issues such as differences among > states' Medicaid enrollment eligibility rules for children. In addition, > the authors suggest that researchers review the structure of care (i.e., > the distribution and locations of providers and clients), the health care > process (including clients' use of specific types of services and their > plan-enrollment patterns), and outcomes of health care to determine > quality measures for evaluation. > > The authors observe that states differ in the ways they implement Medicaid > managed care programs and in the scope of their programs. They conclude > that "the application of child health services research techniques to > evaluations of various managed care models allows for communication of > successes among states and avoidance of problem aspects." > > Cooper WO, Kuhlthau K. 2001. Evaluating Medicaid Managed Care Programs > for Children. Ambulatory Pediatrics 1(2):112-116. Available at > ume=001&issue=02>. > > ************************************************************ > > To subscribe to the MCH Alert, send an e-mail message to > MCHALERT@LIST.NCEMCH.ORG, with SUBSCRIBE in the subject line. You do not > need to enter any text in the body of the message. > > To unsubscribe from the MCH Alert, send an e-mail message to > MCHALERT@LIST.NCEMCH.ORG, with UNSUBSCRIBE in the subject line. You do not > need to enter any text in the body of the message. > > ************************************************************ > > The MCH Alert is not copyrighted. Readers are free to duplicate and use > all or part of the information contained in this publication. In > accordance with accepted publishing standards, the National Center for > Education in Maternal and Child Health (NCEMCH) requests acknowledgment, > in print, of any information reproduced in another publication. > > Please include the following citation when reproducing entire sections of > the MCH Alert in electronic or paper form: > MCH Alert. 2001. Arlington, VA: National Center for Education in > Maternal and Child Health. . > > The editors welcome your submissions, suggestions, and questions. Please > contact us at the address below. > > EDITOR: Phuong Huynh > COPY EDITOR: Ruth Barzel > FOUNDING EDITOR: Laura Kavanagh > > National Center for Education in Maternal and Child Health > 2000 15th Street North, Suite 701 > Arlington, VA 22201 > (703) 524-7802 > (703) 524-9335 FAX > E-mail: phuynh@ncemch.org > Web site: http://www.ncemch.org > > > The MCH Alert is produced by the National Center for Education in Maternal > and Child Health under its cooperative agreement (MCU-119301) with the > Maternal and Child Health Bureau, Health Resources and Services > Administration, U.S. Department of Health and Human Services. > > ************************************************************ > > > > .