Friday, October 04, 2013

CitySquare has been involved from the start: Health and Wellness Alliance for Children

The Health & Wellness Alliance for Children (the Alliance) is a coalition with the goal that “Every child achieves their fullest health, well-being, and potential.”

·        The Alliance plans to use a “collective impact” approach to work across sectors, including health, education, government, the faith community, nonprofit service providers, and others, to form and implement a common agenda for change in children’s health.
·         The initial clinical focus will be children’s asthma, though over time the Alliance plans to tackle children’s health across issues.
·         The initial geographic focus will be on Dallas County, though the Alliance is working with partners throughout North Texas.
Why asthma?
·         While there are many health issues that demand our community’s attention, it is important to focus on one area in order to have a measurable impact.
·         Addressing asthma allows us to focus on several areas that are crucial to children’s health overall: improving financial and physical access to care, improving quality of health care delivery, equipping children and families with tools for wellness, creating asthma-healthy physical environments.
·         The Alliance can use its experience with asthma to expand focus to other areas in the near future.
·         Asthma and other pulmonary illnesses are the top causes for admission to the emergency department at Children’s Medical Center, indicating a real community need.
·         Other communities around the country have had great success in using a coalition approach to improve child asthma.
Who is involved in this effort?
·      The Steering Committee and Working Groups include representatives from many organizations across North Texas, including hospitals, physicians, school administrators, school nurses, the faith community, family health and wellness service providers, urban planners, city and state government, and others.
·         Children’s Medical Center (Children’s) has committed to catalyzing this effort. However, the Alliance is comprised of and led by a cross-section of Dallas community stakeholders committed to children’s health. The effort is and will be driven by the community, not just one organization or sector. 
·     Children and their families have been involved since the start in interviews and workshops to better understand the challenges they face and potential solutions.
 Dallas County Asthma Data
Asthma outcomes
·         Approximately 60,000 children in Dallas have asthma, 9% of all Dallas children[i]
·         In Texas, 54% of children with asthma missed at least one school day per year due to their condition[ii]
·         In 2012, nearly 1500 children in Dallas County visited an emergency room or were admitted to a hospital due to asthma[iii]
·         The hospitalization rate for African-American children is 3.8 times the rate of white children in Dallas (2010)[iv]
·       Annual economic costs to Dallas including cost to families and to medical care facilities across the community is estimated to be a staggering $60M[v]
Potential contributing conditions
·        18% of Dallas children don’t have health insurance; this exceeds the 15% fraction across TX, which is the highest percentage of uninsured children of any US state (2010)[vi]
·         While 46% of Dallas children are covered by Medicaid and CHIP, it is estimated that 76% percent of Dallas physicians would not accept new Medicaid or CHIP patients[vii]
·         Children with asthma are especially susceptible to the effects of ozone pollution, and Dallas’s ozone levels exceed the EPA’s legal standard[viii]
·         Child poverty in Dallas: 29% of Dallas kids live in poverty; 28% have inadequate food and nutrition; 35% live in a single-parent home[ix]

[i] Harrison, Whitney (MPH, Epidemiologist), Texas Asthma Control Program, Dept. of State Health Services. “Asthma Morbidity and Mortality in Texas and Health Region 3.” October 17, 2011.
[ii] Harrison, 2011.
[iii] Dallas Fort Worth Hospital Council Foundation, 2013.
[iv] Texas Health Care Information Collection (THCIC), Inpatient Hospital Discharge Public Use Data File, 2010.
[v] The cost estimate per child based on: Li Yan Wang et. al; “Direct and Indirect Cost of Asthma in School age Children”.  Preventing Chronic Disease (January 2005).  This number is multiplied by the number of children with asthma in Dallas.
[vi] Harris, J., Hogan, J., and the Beyond ABC Advisory Board, ed. Beyond ABC:  Assessing Children’s Health in Dallas County, 2011.
[vii] “Texas State Health Facts”. Henry J. Kaiser Family Foundation. ; Harris, J., Hogan, J., and the Beyond ABC Advisory Board, ed. Beyond ABC:  Assessing Children’s Health in Dallas County, 2011.
[viii] “Dallas-Fort Worth: Current Attainment Status”. Texas Commission on Environmental Quality. <>.
[ix] Harrison, 2011.

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