HEALTH
Delayed Prenatal Care
DEFINITION
Delayed prenatal care is the percentage of pregnant women
beginning prenatal care in the second or third trimester of pregnancy
or receiving no prenatal care at all. Data are reported by place of
mother's residence, not place of infant's birth.
SIGNIFICANCE
Timely and comprehensive prenatal care significantly increases
the likelihood of delivering a healthy infant of normal birthweight.
Delaying the start of prenatal care to the second trimester increases
the health risks for both mother and baby.
Women who begin prenatal care in the first trimester are advised earlier about smoking, nutrition and other exposures that affect fetal development. Their health care providers have an early opportunity to prevent, detect, and treat pregnancy-related conditions or complications.
Early prenatal care is especially important for women at increased medical or social risk. Barriers to receiving care are greatest for poor, young or minority women due to lack of health insurance, transportation, education and child care, and because of language and cultural differences.
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Figure 3-1: DELAYED PRENATAL CARE IN CORE CITIES
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Figure 3-2: WOMEN RECEIVING DELAYED PRENATAL CARE BY RACE
Table 3-1: Delayed Prenatal Care, Rhode Island, 1987-1991
city/Town Births Delayed care % delayed care --------------------------------------------------------- Barrington 972 48 4.9 Bristol 1,366 151 11.1 Burrillville 1,005 88 8.8 Central Falls 2,005 442 22.0 Charlestown 563 50 8.9 Coventry 2,031 188 9.3 Cranston 4,432 443 10.0 Cumberland 1,704 147 8.6 East Greenwich 599 52 8.7 East Providence 3,213 361 11.2 Exeter 382 26 NA Foster 287 23 NA Glocester 571 43 7.5 Hopkinton 535 49 9.2 Jamestown 318 25 NA Johnston 1,711 154 9.0 Lincoln 1,093 93 8.5 Little Compton 186 25 NA Middletown 1,329 188 14.1 Narragansett 898 68 7.6 Newport 2,100 405 19.3 New Shoreham 66 4 NA North Kingstown 1,615 122 7.6 North Providence 1,866 170 9.1 North Smithfield 497 43 NA Pawtucket 6,015 972 16.2 Portsmouth 1,069 80 7.5 Providence 16,009 3,764 23.5 Richmond 409 34 NA Scituate 656 48 7.3 Smithfield 1,015 79 7.8 South Kingstown 1,349 87 6.4 Tiverton 843 100 11.9 Warren 816 103 12.6 Warwick 5,414 488 9.0 Westerly 1,629 168 10.3 West Greenwich 261 27 NA West Warwick 2,327 284 12.2 Woonsocket 3,754 648 17.3 Rhode Island 72,910 10,290 14.1 Core Cities 29,883 6,231 20.8 Remainder of State 43,027 4,059 9.4 NA: Small numbers of births make percentage calculations unreliable.
Source of data for table
----------------------------
Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, 1987 to 1991. Hispanic data are for 1989 to 1991 only. Core cities are Providence, Pawtucket, Woonsocket, Newport, and Central Falls.
references for indicator
----------------------------
All data are from the Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, 1987 to 1991, unless otherwise noted.
Healthy People 2000 - Rhode Island: The Health of Minorities in Rhode Island, (1993), Office of Health Statistics, Rhode Island Department of Health: Providence, RI.
Prenatal Care in the United States: A State and Country Inventory, Vol.1, (1989), The Allen Guttmacher Institute: New York, NY & Washington DC.
Starting Points: Meeting the Needs of Our Youngest Children, (1994), Carnegie Corporation: New York, NY.
Beyond Rhetoric: A New American Agenda for Children and Families: Final Report of the National Commission on Children, (1991), U.S. Government Printing Office: Washington DC.
Prenatal Care: Reaching Mothers, Reaching Infants, (1988), Institute for Medicine, National Academy Press: Washington DC.
Low Birthweight Infants
DEFINITION
Low birthweight infants in the percentage of live births
weighing under 2,500 grams (5.5 pounds). The data are reported by
place of mother's residence, not place of infant's birth.
SIGNIFICANCE
A baby's birthweight is a key indicator of newborn health and is
directly related to the infant's survuval, health, and development.
Almost 60% of infants who die in the first year of life were born
with low birthweight.
Babies born weighing less than 5.5 pounds are at greater risk for physical and mental problems. Babies born weighing less than 3.3 pounds are especially high risks for chronic lung and respiratory problems, visual and hearing impairments, mental retardation, and developmental and learning disabilities.
Low birthweight rates for Black infants are akmost twice those for White infants, and are higher than those for Asians and other racial groups.
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Figure 3-3: LOW BIRTHWEIGHT INFANTS BY RACE
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Figue 3-4: LOW BIRTHWEIGHT INFANTS IN CORE CITIES
Table 3-2: LOW BIRTHWEIGHT INFANTS BY CITY AND TOWN
Number % low city/Town Births Low Birthweigt Birthrate --------------------------------------------------------- Barrington 972 35 3.6 Bristol 1,366 63 4.6 Burrillville 1,005 52 5.2 Central Falls 2,005 169 8.4 Charlestown 563 30 5.3 Coventry 2,031 99 4.9 Cranston 4,432 231 5.2 Cumberland 1,704 74 4.3 East Greenwich 599 31 5.2 East Providence 3,213 174 5.4 Exeter 382 23 NA Foster 287 13 NA Glocester 571 25 4.4 Hopkinton 535 28 5.2 Jamestown 318 13 NA Johnston 1,711 89 5.2 Lincoln 1,093 49 4.5 Little Compton 186 6 NA Middletown 1,329 76 5.7 Narragansett 898 38 4.2 Newport 2,100 101 4.8 New Shoreham 66 2 NA North Kingstown 1,615 75 4.6 North Providence 1,866 99 5.3 North Smithfield 497 19 NA Pawtucket 6,015 361 6.0 Portsmouth 1,069 54 5.1 Providence 16,009 1,326 8.3 Richmond 409 18 NA Scituate 656 28 4.3 Smithfield 1,015 40 3.9 South Kingstown 1,349 75 5.6 Tiverton 843 50 5.9 Warren 816 51 6.3 Warwick 5,414 290 5.4 Westerly 1,629 96 5.9 West Greenwich 261 11 NA West Warwick 2,327 129 5.5 Woonsocket 3,754 269 7.2 Rhode Island 72,910 4,412 6.1 Core Cities 29,883 2,226 7.4 Remainder of Stat 43,027 2,186 5.1 NA: Small number of births make percent calculations unreliable.
Source of Data for table
___________________________
Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, 1987 - 1991. Hispanic data are for 1989 to 1991 only. Core cities are Providence, Pawtucket, Woonsocket, Newport, and Central Falls.
references for indicator
___________________________
All data are from the Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, 1987 to 1991, unless otherwise noted.
The Health of America's Children, Maternal and Child Health Data Book, (1992), Children's Defense Fund: Washington D.C.
Starting Points: Meeting the Needs of Our Youngest Children, (1994), Carnegie Corporation: New York, NY
The State of America's Children Yearbook: 1994, (1994), Children's Defense Fund: Washington D.C.
Healthy People 2000 - Rhode Island: The Health of Minorities in Rhode Island, (1993), Office of Health Statistics, Rhode Island Department of Health: Providence, RI
Infant Mortality
DEFINITION
Infant mortality is the number of deaths occuring to
infants under one year of age per 1,000 live birhts. Data are
reported by place of mother's residence, not place of infant's birth.
SIGNIFICANCE
Infant mortality rates are closely linked to a community's social
and economic conditions. Communities with multiple problems such as
poverty, poor housing conditions, and unemployment tend to have
higher infant mortality rates than more advantaged communities.
Risk factors contributing to infant mortality include lack of health and prenatal care, inadequate nutrition and poor living conditions. Some of the health factors associated with infant deaths include congenital birth defects, complications resulting from early delivery and low birthweight, repitory problems.
Over the past ten years, Rhode Island's Black infant mortality rate has declined 56 percent. Despite this progress, the Black infant mortality rate continues to be twice that for White infants.
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Figure 3-5: Rhode Island Infant Mortality Rates by Race
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U.S. INFANT MORTALITY RATE RANKS BEHIND OTHER COUNTRIES
Infant mortality rates are used by
the World Health Organization as a primary measure of the overall
social and economic health of communities worldwide.
Each year in the United States
almost 40,000 infants die before their first birthday.
The overall United States infant
mortality rate ranks twenty-second worldwide. The U.S. infant
mortality rate for Black infants ranks fortieth when compared with
other countries' overall rates.
In Rhode Island in 1991, 118
infants died before their first birthday. More than half of those
deaths occured in the core cities of Providence, Pawtucket,
Woonsocket, Newport, and Central Falls.
Table 3-3: Number of Infant Deaths, Rhode Island, 1987-1991
city/Town Births Infant Deaths Rate/1000 Births ------------------------------------------------------------ Barrington 972 6 6.2 Bristol 1,366 4 2.9 Burrillville 1,005 11 10.9 Central Falls 2,005 25 12.5 Charlestown 563 6 10.7 Coventry 2,031 17 8.4 Cranston 4,432 27 6.1 Cumberland 1,704 14 8.2 East Greenwich 599 8 13.4 East Providence 3,213 25 7.8 Exeter 382 8 NA Foster 287 2 NA Glocester 571 4 7.0 Hopkinton 535 5 9.3 Jamestown 318 4 NA Johnston 1,711 12 7.0 Lincoln 1,093 2 1.8 Little Compton 186 10 NA Middletown 1,329 9 6.8 Narragansett 898 7 7.8 Newport 2,100 22 10.5 New Shoreham 66 1 NA North Kingstown 1,615 8 5.0 North Providence 1,866 14 7.5 North Smithfield 497 3 NA Pawtucket 6,015 62 10.3 Portsmouth 1,069 7 6.5 Providence 16,009 168 10.5 Richmond 409 1 NA Scituate 656 3 4.6 Smithfield 1,015 2 2.0 South Kingstown 1,349 11 8.2 Tiverton 843 8 9.5 Warren 816 2 2.5 Warwick 5,414 35 6.5 Westerly 1,629 9 5.5 West Greenwich 261 1 NA West Warwick 2,327 17 7.3 Woonsocket 3,754 46 12.3 Rhode Island 72,910 626 8.6 Core Cities 29,883 323 10.8 Remainder of Sta 43,027 303 10.1 NA: Small numbers of births make rate calculations unreliable.
Source of Data for table
___________________________
Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, Death Files, 1987-1991. Hispanic data are for 1989 to 1991 only. Core cities are Providence, Pawtucket, Woonsocket, Newport, and Central Falls.
references for indicator
___________________________
All data are from the Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, 1987-1991, unless otherwise noted.
Healthy People 2000 - Rhode Island: The Health of Minorities in Rhode Island, (1993), Office of Health Statistics, Rhode Island Department of Health: Providence, RI
KIDS COUNT Data Book 1994: State Profiles of Child Well-Being, (1994), Annie E. Casey Foundation: Baltimore, MD.
The Health of America's Children, Maternal and Child Health Data Book, (1992), Children's Defense Fund: Washington D.C.
The State of the World's Children: 1994, (1994), United Nations Children's Fund (UNICEF): New York, NY; ranking based on 1991 infant mortality statistics from the National Center for Health Statistics.
Births to Unmarried Teens
DEFINITION
Births to unmarried teens is the number of births to
unmarried teen girls age 15 to 19, per 1,000 teen girls. Data are
reported by mother's place of residence, not the place of the
infant's birth.
SIGNIFICANCE
Early childbearing threatens the development of teen parents as
well as their children. Being a teen parent seriously limits
subsequent education, employment prospects, and lifetime earnings.
Children of teen mothers begin life at a disadvantage, in part beacuase teen nothers are less likely to obtain adequate prenatal care and are less likely to have the financial resources to promote optimal child development. Children born to teenage mothers are more likely to suffer poor health, experience learning and behavioral problems, live in poverty and become teen parents themselves.
Youth who live in poverty, have poor basic skills or poor school attendance are at especially high rick fro teen parenting. Prevention efforts are most effective when they occur in the context of better life options and increased economic opportunities for both male and female teens.
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Figure 3-6: Women With Delayed Prenatal Care by Age of Mother
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FACTS ABOUT BIRTHS TO TEENS IN RHODE ISLAND
Between 1988 and 1992:
There were 5,883 births to Rhode
Island teenagers ages 15 to 19. Of these, 4 out of 5 were to
unmarried teens.
16 babies were born to girls age 12
and 13. 89 babies were born to girls age 14.
1 in 10 births in rhode island were
to women less than 20 years of age.
2 out of 3 teen births were to
girls in the core cities of Providence, Pawtucket, Woonsocket,
Newport, and Central Falls.
Table 3-4: BIRTHS TO UNMARRIED TEENS, AGE 15-19, RHODE ISLAND, 1988-1991
number
of teen girls births to rate per
city/Town ages 15-19 unmarried Teen 1,000 teens
---------------------------------------------------------------------
Barrington 475 13 6.8
Bristol 957 49 12.8
Burrillville 517 54 26.1
Central Falls 584 218 93.3
Charlestown 153 19 31.0
Coventry 1,019 94 23.1
Cranston 1,990 145 18.2
Cumberland 910 50 13.7
East Greenwich 405 12 7.4
East Providence 1,496 153 25.6
Exeter 172 13 18.9
Foster 140 6 10.7
Glocester 365 23 15.8
Hopkinton 221 32 36.2
Jamestown 128 5 9.8
Johnston 753 66 21.9
Lincoln 544 34 15.6
Little Compton 81 7 21.6
Middletown 472 40 21.2
Narragansett 384 17 11.1
Newport 1,153 134 29.0
New Shoreham 11 0-
North Kingstown 774 62 20.0
North Providence 887 55 15.5
North Smithfield 374 15 10.0
Pawtucket 2,234 522 58.4
Portsmouth 511 23 11.2
Providence 7,284 1,746 59.9
Richmond 169 24 35.5
Scituate 334 15 11.2
Smithfield 890 19 5.3
South Kingstown 2,255 53 5.9
Tiverton 462 28 15.2
Warren 328 30 22.9
Warwick 2,533 230 22.7
Westerly 615 75 30.5
West Greenwich 127 18 35.4
West Warwick 868 125 36.0
Woonsocket 1,484 439 73.9
Rhode Island 35,059 4,663 33.2
Core Cities 12,739 3,059 60.0
Remainder of State 22,320 1,604 18.0
Source of Data for table
___________________________
Rhode Island Department of Health, Maternal and Child Health Database, Birth Files, 1988 to 1991. Core cities are Providence, Pawtucket, Woonsocket, Newport, and Central Falls.
references for indicator
___________________________
All data are from the Rhode Island Department of Health, Division of Family Health, Maternal and Child Health Database, 1988-1991.
Starting Points: Meeting the Needs of Our Youngest Children, (1994), Carnegie Corporation: New York, NY
Beyond Rhetoric: A New American Agenda for Children and Families: Final Report of the National Commission on Children, (1991), U.S. Government Printing Office: Washington D.C.
Sex and America's Teenagers, (1994), The Allen Guttmacher Institute, New York, N.Y.
1994 Annual Report, (1995), Children's Defense Fund: Washington D.C.
Woman and Children Receiving WIC
DEFINITION
Woman and children receiving WIC is the percentage of
eligible women, infants and children served by the Special
Supplemental Food Program for Women, Infants and Children (WIC).
SIGNIFICANCE
The Special Supplemental Food Program for Women, Infants and
Children is a preventative program providing nutrious food, nutrition
education and improved access to health care.
This federally funded program serves pregnant, postpartum and breastfeeding women, infants and children less than five years of age who are at nutritional risk, based on abnormal weight gain during pregnancy, iron-deficiency anemia or other specific health risks. Household income must be below 185% of the poverty level.
In Rhode Island, the funded allocation of 22,030 serves about 67% of eligible women, infants and children.
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Figure 3-7: Women , Infants and Children Served by WIC, Rhode Island 1995
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WIC PREVENTS HEALTH PROBLEMS AND IS COST-EFFECTIVE
According to the Carnegie Corporation Report, Starting Points: Meeting the Needs of Our Youngest Children, research indicates that WIC prevents health problems in pregnant women and young children and is cost-effective.
WIC links the distribution of food
to other health services, including prenatal care. Participation in
WIC reduces by 15 to 25% the chance that a pregnant women will
deliver a premature or low birthweight infant. Every $1 spent on WIC
is estimated to save $3 in medical costs. The greatest cost-savings
associated with the WIC program occur during the dirst year of life
due to reduced medical costs.
WIC increases the likelihood that
women will receive early, regular prenatal care and that their
children will get regular pediatric care and immunizations. Mothers
and children who are poor, minority, or poorly educated benefit most.
WIC has been shown to protect
infants and children from nutrition-related health problems during
critical periods of growth and development. By protecting a child's
cognitive development, WIC results in savings for special education
thatmay have otherwise have been incurred due to malnutrition in
infancy and early childhood.
Table 3-5: Women, Infants and Children Receiving WIC, Rhode Island, January, 1995
estimated number percent of eligible city/town number eligibl participating participating ----------------------------------------------------------------------- Barrington 211 62 29 Bristol 403 220 54 Burrillville 427 257 60 Central Falls 1,642 1,304 79 Charlestown 105 75 71 Coventry 592 278 47 Cranston 1,753 937 53 Cumberland 554 209 38 East Greenwich 241 63 26 East Providence 1,205 813 67 Exeter 13 58 >100 Foster 10 42 >100 Glocester 293 52 18 Hopkinton 33 97 >100 Jamestown 96 17 18 Johnston 598 320 53 Lincoln 360 159 44 Little Compton 63 19 30 Middletown 694 293 42 Narragansett 71 105 >100 Newport 1,332 724 54 New Shoreham 39 0 0 North Kingstown 370 242 65 North Providence 262 359 >100 North Smithfield 59 70 >100 Pawtucket 3,198 2,550 80 Portsmouth 249 98 39 Providence 11,280 8,157 72 Richmond 24 90 >100 Scituate 75 71 95 Smithfield 174 96 55 South Kingstown 402 258 64 Tiverton 260 146 56 Warren 156 178 >100 Warwick 1,613 865 54 Westerly 648 309 48 West Greenwich 38 25 66 West Warwick 777 535 69 Woonsocket 2,566 1,753 68 Rhode Island 32,887 21,906 67 Core Cities 20,018 14,488 72 Remainder of State 12,869 7,418 58 * Estimates are based on 1990 Census, and do not reflect recent increases in eligible population.
Source of Data for table
___________________________
Rhode Island Department of Public Health, Division of Family
Health, WIC Program, January 1995. Core cities are Providence,
Pawtucket, Woonsocket, Newport and
Central Falls.
references for indicator
___________________________
All data are from the Rhode Island Department of Health, Division
of Family Health, WIC
program, January, 1995, unless otherwise noted.
Starting Points: Meeting the Needs of Our Youngest Children, (1994), Carnegie Corporation: New York, NY
Beyond Rhetoric: A New American Agenda for Children and Families: Final Report of the National Commission on Children, (1991), U.S. Government Printing Office: Washington D.C.
Statement on The Link Between Nutrition and Cognitive Development in Children, (1995), Tufts University, School of Nutrition, Center on Hunger, Poverty and Nutrition Policy, Medford, MA.
Children Receiving School Lunch
DEFINITION
Children receiving school lunch is the percentage of
children in public schools who are eligible for free or reduced
lunches, and are enrolled in the program. Half-day kindergarten,
private schools and residential child care centers are not included
in the calculation
SIGNIFICANCE
The National School Lunch Program is an entitlement program
providing nutritious meals to children at participating schools.
Meals must meet specific nutritional requirements in order to qualify
for federal funds.
USDA research shows that children who participate in school lunch have better butrional intake than those who do not. For some children, a school meal is their only nutritious meal of the day. Children from low income families depend on the School Lunch Program for one-third to one-half of their nutritional intake each day.
Undernutrition during any period of childhood can have detrimental effects on a child's cognitive development. The longer a child's nutrional and developmental needs go unmet, the greater the risk of cognitive impairment.
To receive a reduced price meal, household income must be below 185% of the federal poverty level. 5,333 Rhode Island children receive reduced-price lunch.
For free meals, household income must fall below 130% of poverty. Children in food stamp or AFDC households are automatically eligible for free meals. 35,735 Rhode Island children receive free lunch.
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THE SCHOOL BREAKFAST PROGRAM
The School Breakfast program
provides federal funds to schools to offer nutrious meals to
students. Although the School Breakfast Program is an entitlement
program (meaning federal funds are available to pay the cost for all
eligible students), it is not accessible to many children who need it
because it is not a mandatory program and most school districts do
not offer it.
According to The Food Research and
Action Center in Washington, DC, 38.9% of Rhode Island's 360 schools
offer breakfast, well below the national average of 64.2%. Rhode
Island ranked 44th among the states in schools offering the School
Breakfast Program.
An increasing number of schools in
Rhode Island are participating in the School Breakfast Program. In
September of 1994, 140 schools were offering breakfast, up from 119
the previous year.
According to the Center on Hunger,
Poverty and Nutrition Policy at Tufts University, children who
participate in the School Breakfast Program have been shown to
improve in the areas of standardized achievement test scores,
attendance, and arriving at school on time.
Table 3-7: School Children Enrolled in Free And Reduced Price Lunch, Rhode Island, 1994
number of eligible for free or reduced price school district students number percent ----------------------------------------------------------------------- Barrington 2,578 78 3 Bristol-Warren 3,774 861 23 Burrillville 2,768 618 22 Central Falls 2,528 2,223 88 Chariho 3,341 445 13 Coventry 5,065 753 15 Cranston 9,248 1,915 21 Cumberland 4,220 456 11 East Greenwich 1,984 171 9 East Providence 5,676 1,740 31 Exeter-W. Greenwich 1,655 224 14 Foster 329 55 17 Foster-Glocester 1,303 101 8 Glocester 761 111 15 Jamestown 513 35 7 Johnston 2,974 435 15 Lincoln 2,692 265 10 Little Compton 330 44 13 Middletown 2,761 521 19 Narragansett 1,778 234 13 Newport 2,985 1,112 37 New Shoreham 107 6 6 North Kingstown 3,919 466 12 North Providence 3,323 376 11 North Smithfield 1,589 142 9 Pawtucket 8,305 3,900 47 Portsmouth 2,499 195 8 Providence 21,332 15,741 74 Scituate 1,484 100 7 Smithfield 2,475 201 8 South Kingstown 3,395 450 13 Tiverton 1,928 333 17 Warwick 11,251 1,920 17 Westerly 2,947 551 19 West Warwick 3,716 951 26 Woonsocket 5,817 3,044 52 Rhode Island 134,083 41,068 31 Core Cities 40,967 26,020 64 Remainder of State 93,116 15,048 16
Source of Data for table
___________________________
Rhode Island Department of Elementary and Secondary Education, Office of School Food Services, Fall, 1994. Core cities are Providence, Pawtucket, Woonsocket, Newport and Central Falls.
references for indicator
___________________________
All data are from the Rhode Island Department of Elementary and Secondary Education, Office of School Food Services, unless otherwise noted.
Statement on The Link Between Nutrition and Cognitive Development in Children, (1995), Tufts University, School of Nutrition, Center on Hunger, Poverty and Nutrition Policy, Medford, MA.
School Breakfast Scorecard, October 1993, (1993), Food Research and Action Center, Washington DC.
Children with Lead Poisoning
DEFINITION
Children with lead poisoning is the rate of confirmed lead
poisoning as of September 30, 1994 per 1,000 children age three,
eligible to enter kindergarten in the Fall of 1996 (i.e. born between
September 1, 1990 and August 31, 1991).
SIGNIFICANCE
Childhood lead poisoning is one of the most common pediatric
health problems and is entirely preventable. Infants and young
children are most susceptible to the toxic effects of lead. Lead’s
effects on the developing central nervous system may be irreversible.
Even low levels of lead exposure can result in learning disabilities,
behavioral problems and lower I.Q. Higher levels of lead exposure can
result in serious health problems and can lead to coma, convulsions
and death.
While children of all back-grounds are at risk, low-income children and children of color are particularly likely to be affected by lead poisoning. Inadequate nutrition and anemia, more common in poor children, increase a child’s suscep-tibility to lead poisoning. Lead-based paint and lead-contaminated dusts and soils remain the primary sources of lead exposure for children. Living in substandard housing places children at risk for lead poisoning.
Table 3-8: Lead poisoning In Chilfren Entering Kindergarten in The Fall of 1996
total number number screened positive for lead poison confirmed poisoning city/town 1990-1991 births screened number % with confirmation number rate/1000 Barrington 190 259 4 0 0 0 Bristol 289 289 12 25 3 10.4 Burrillville 197 176 11 27 3 17 Central Falls 406 446 104 40 41 91.9 Charlestown 113 92 3 33 1 10.9 Coventry 410 248 11 9 1 0 Cranston 926 793 62 29 17 21.4 Cumberland 358 310 22 32 7 22.6 East Greenwich 123 93 2 50 1 10.7 East Providence 624 626 43 12 4 6.4 Exeter 72 57 5 0 0 0 Foster 63 55 2 50 1 18.2 Glocester 106 89 8 25 1 11.2 Hopkinton 119 80 4 25 1 12.5 Jamestown 58 66 6 0 0 0 Johnston 381 288 18 28 6 17.4 Lincoln 242 192 10 20 2 10.4 Little Compton 38 45 3 0 0 0 Middletown 290 245 8 38 3 12.2 Narragansett 171 193 14 21 3 15.5 Newport 425 486 33 33 9 18.5 New Shoreham 12 26 2 0 0 0 North Kingstown 322 308 10 30 3 9.7 North Providence 407 318 24 29 7 22.0 North Smithfield 113 82 4 50 0 0 Pawtucket 1,204 1,278 155 43 65 50.9 Portsmouth 223 211 4 0 0 0 Providence 3,220 3,766 965 59 573 152.2 Richmond 81 82 9 22 2 24.4 Scituate 130 104 5 0 0 0 Smithfield 199 170 7 43 3 17.6 South Kingstown 274 351 29 17 5 14.2 Tiverton 158 182 7 43 3 16.5 Warren 169 165 7 29 2 12.1 Warwick 1,130 745 46 41 18 24.2 Westerly 356 182 13 54 6 33.0 West Greenwich 49 42 2 50 1 23.8 West Warwick 460 229 20 55 6 26.2 Woonsocket 746 918 127 38 46 50.1 Rhode Island 14,847 14,855 1,953 52 929 62.5 Core Cities 6,001 6,894 1,384 53 734 122.3 Remainder of State 8,846 7,961 569 34 111 12.5 * In 84 of these cases town of residence is unknown, these are not included in the city/town listing.
________________________________________
Notes on Table
Estimated number of children entering school in the Fall of 1996
(born between 9/1/90 and 8/31/91); number screened for lead poisoning
as of September 30, 1994; number of children with elevated blood
levels (>14ug/dL); percent of children with elevated blood levels
who obtained a confirmation test; number of children with confirmed
lead poisoning (>14ug/dL); rate of confirmed lead poisoning per
1,000 children born between 9/1/90
and 8/31/91, Rhode Island, September 30, 1994.
Source of Data for table
___________________________
Rhode Island Department Health, Division of Family Health, September 30, 1994. Core cities are Providence, Pawtucket, Woonsocket, Newport and Central Falls.
references for indicator
___________________________
All data are from the Rhode Island Department of Health, Division of Family Health, unless otherwise noted.
Preventing Lead Poisoning in Young Children: A Statement by the Centers for Disease Control, (1991), U.S. Department of Health and Human Services: Washington D.C.
America's Children At Risk: A National Agenda for Legal Action, (1993), American Bar Association: Chicago, IL.
Additional Children's Health Issues
Rhode Island KIDS COUNT is dedicated to providing a comprehensive profile of the well-being of children in Rhode Island. However, there are some important issues affecting children for which there is a lack of available city and town data. Some of these critical health issues are as follows:
Access To Dental Care
Children who go without dental care or who receive an inadequate level of dental care can develop long-term oral health problems and are more likely to experience dental conditions that require emergency treatment. Chronic dental problems can lead to a poor self-image, a lack of concentration, absenteeism and reduced school performance.
Access to dental care is a major obstacle confronting children from poor, working poor and uninsured families. There is a shortage of private providers willing to accept Medical Assistance patients due to the low level of reimbursement for services. Only three community health centers in the state provide dental care; all have waiting lists of up to a year for new patients.
Programs such as Head Start, Donated Dental Services of Rhode Island (for disabled children), Travelers Aid’s program for homeless teens, a targeted school-based sealant program, and a new clinic at St. Joseph Hospital help to increase access. However, children’s unmet needs for dental care are substantial. In Providence alone it is estimated that 16,000 children do not have adequate dental care.
Childhood Immunization
Children need to be immunized on schedule to guard against a variety of preventable illnesses. It is estimated that every dollar spent on immunization saves ten dollars in later medical costs. Efforts are underway in communities across the country to increase the number of fully-immunized children through neighborhood outreach programs that communicate directly with parents and provide easy access to immunization sites.
Nationally, only 55% of all two- year-olds were immunized according to the recommended schedule. Rhode Island’s immunization rate exceeds the national average. Sixty-nine percent of Rhode Island children are fully immunized by 24 months of age. Retrospective surveys conducted by the RI Department of Health reveal significant discrepan-cies in the completeness of immuni-zations between children in high risk communities and the rest of the state*. These discrepancies appear as early as three months of age, widen by seven months and persist throughout the first two years. In 1993, only one third of children in the state’s high risk communities were fully immunized by 19 months of age. By 24 months, the rate in these communities reached 56% –– still well below the 90% goal.
*The high risk communities identified by the Department of Health for the Retrospective Study were: Central Falls, East Providence, Newport, Pawtucket, Providence, and Woonsocket.
Children Without Health Insurance
Access to primary health care, including preventive care (well-child visits) and comprehensive treatment for serious illnesses and injuries is vital to every child’s healthy growth and development. Uninsured children’s lack of access to primary care leads to health problems that can severely compromise their long-term health and development. An estimated 7.5% of Rhode Island’s children are uninsured.
Family income and a parent’s employment status are the most important factors determining whether children have health care coverage and the type of coverage they have. Many low-income children whose families do not qualify for Medicaid are uninsured either because the parent’s employer does not offer family benefits or because low wages preclude monthly co-payments for the more expensive family coverage plans. Other children whose parent’s cycle in and out of seasonal work are covered for only a portion of the year.
Children's Mental Health
Children’s emotional well-being is essential to their growth and development. An estimated 12 to 15 percent of American children suffer from mental disorders. While the most frequent disorders treated include hyperactivity, attention deficit disorder and other conduct disorders, more than 5 percent of school-age children and adolescents suffer from depression and anxiety problems. 70% of children with disorders do not access mental health services.
In Rhode Island, the eight Community Mental Health Centers provided services to a total of 3,729 children and youth during the 1993–94 fiscal year. Bradley Hospital, Rhode Island’s largest psychiatric center for children and adolescents admitted 548 children and youth to its hospital programs for the treatment of emotional disorders in 1994.
Mental health professionals are emphasizing early intervention in order to keep children’s emotional problems from intensifying. The Child and Adolescent Services System Program (CASSP) was established by the National Institute of Mental Health in 1984 to promote local systems of care that are family-focused, multi-disciplinary and tailor support services to meet the individual needs of the child and family. The CASSP has generally resulted in fewer children placed in institutional or residential treatment settings or shorter stays for the children who are placed.
[Table of Contents][Safety]
