2010 Rhode Island Kids Count Factbook

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010 90 80 70 60 50 40 30 20 Vaccination 10 Coverage Among Children, Ages 19 Months to 35 Months, United States and Rhode Island, 2008 0 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% RI 88% 85% U.S. 97% 94% 94% 92% 89% 91% 97% 94% 93% 91% 78% 76% 4+ DTaP 3+ Polio 1+ MMR 3+ Hib 3+ HepB 1+ Varicella 4:3:1:3:3:1 Series Source: Centers for Disease Control and Prevention, National Immunization Survey, 2008. ◆ Rhode Island ranks 15th in the nation for the completion of the full Series in 2008, an improvement from 38th in 2007. 20,21 Immunizations for Elementary and Middle School Students ◆ The 2008-2009 Rhode Island School Immunization Assessment (comprised of data collected directly from student health records) included an analysis of 2,751 randomly selected records from students at kindergarten entry (5-7 years of age) and at middle school entry (11-13 years of age) across 132 randomly selected public and private schools. Over 94% of entering kindergarteners were up-to-date on the five immunizations needed for school entry. More than 94% of entering middle school students had three of the four recommended immunizations. 22 Childhood Immunizations Adolescent Immunization ◆ State-level data for immunizations among adolescents ages 13 to 17 are available for the first time through the National Immunization Survey–Teen. In 2008, Rhode Island adolescents ranked best in the U.S. for four immunizations (3+HepB, 1+Varicella (chickenpox), 1+MCV4, and 1+HPV4), 2nd best for two immunizations (2+MMR and 1+Td/Tdap), and 27th for 1+Tdap. In 2008, more than 95% of Rhode Island adolescents had received the 2+MMR, the 3+HepB and the 1+Varicella vaccines, compared with rates below 90% in the U.S. as a whole. 23 ◆ To ensure that all high school seniors are fully vaccinated before beginning college or work, the Rhode Island Immunization Program runs Vaccinate Before You Graduate (VBYG) in high schools throughout the state. The program informs parents and students of the importance of immunization and holds vaccination clinics throughout the year at each participating school. The immunizations are funded by the state’s Vaccines for Children program and are offered at no cost to students. 24 ◆ During the 2008-2009 school year, 72 schools participated in VBYG. Of the 1,676 students enrolled in the program, 98% received one or more immunizations and 86% completed all immunizations for which they were enrolled. The vaccines administered included Hepatitis B, MMR, TdaP, meningococcal (MCV4), varicella (chicken pox), polio, influenza, and the human papillomavirus vaccine (HPV). 25 References 1,4 Centers for Disease Control and Prevention. (n.d.). How vaccines prevent disease. Retrieved January 14, 2010 from www.cdc.gov 2 Centers for Disease Control and Prevention. (2007). Epidemiology and prevention of vaccine-preventable diseases, 10th ed. Atkinson, W., Hamborsky, J., McIntyre, L. & Wolfe, S. (Eds.). Washington, DC: Public Health Foundation. 3,18 Centers for Disease Control and Prevention. (2006). General recommendations on immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 55(RR- 15), 1-48. 5 Centers for Disease Control and Prevention. (n.d.). Why immunize? For parents. Retrieved January 14, 2010 from www.cdc.gov 6 Zhou, F., Santoli, J., Messonnier, M. L., Yusuf, H. R., Shefer, A., Chu, S. Y., Rodewald, L. & Harpaz, R. (2005). Economic evaluation of the 7-vaccine routine childhood immunization schedule in the United States, 2001. Archives of Pediatrics & Adolescent Medicine, 159, 1136-1144. 7 Centers for Disease Control and Prevention. (n.d.). Vaccines for Children Program (VFC). Retrieved January 14, 2010 from www.cdc.gov 8 Birkhead, G. S., Orenstein, W. A. & Almquist, J. R. (2009). Reducing financial barriers to vaccination in the United States: Call to action. Pediatrics, 124(5), s451-S454. 9 Rhode Island Department of Health. (n.d.). Childhood immunization program. Retrieved January 14, 2010 from www.health.ri.gov (continued on page 164) 2010 Rhode Island KIDS COUNT Factbook 55
Access to Dental Care DEFINITION Access to dental care is the percentage of children under age 21 who were enrolled in RIte Care, RIte Share or Medicaid fee-for-service on September 30 who had received dental services at any point during the previous federal fiscal year. SIGNIFICANCE Dental caries (tooth decay) is the most common disease among children five to 17 years old. 1 Children with untreated dental problems are more likely to have problems chewing and swallowing, speech problems and poor school performance due to difficulty concentrating and absenteeism. 2 Insurance is a strong predictor of access to health and dental care. Nearly one in four (24%) uninsured children in the U.S. has unmet dental needs, compared with 6% of those with Medicaid and 4% of those with private health insurance. 3 National estimates indicate that the number of children without dental insurance is 2.6 times greater than the number without medical insurance. 4 The percentage of Rhode Island children with dental insurance increased in the 1990s through the early 2000s (from 62% in 1990 to 76% in 2004, the most recent year for which data are available). 5,6 Children living in poverty are more likely to have severe and untreated tooth decay than higher-income children. Medicaid-eligible children are twice as likely to have dental disease as higherincome children, although children with Medicaid coverage have better access to dental care than those without insurance. For children in low-income families, the efficacy and continuity of public dental insurance is a critical factor in access to dental care. In the U.S., children who have continuous enrollment in public health insurance programs have greater access to dental and medical care than children who have no insurance or are covered for only part of the year. 7,8,9 Children who are uninsured for only part of the year are nearly six times as likely to have an unmet dental need as children who are insured for a year or more. 10 Minority children have the highest rates of tooth decay and untreated dental problems. One in five (19%) Hispanic children in the U.S. has gone for more than two years without a dental visit, compared with 15% of non-Hispanic Black and 14% of non- Hispanic White children. 11,12 Children with special health care needs may have problems finding and accessing providers who are trained and equipped to address their special dental, medical and mobility needs. 13 A dental home can provide comprehensive, continuously accessible, coordinated and family-centered oral health care. 14,15 2004 2005 2006 100 90 80 70 60 50 40 30 20 10 0 Children Enrolled in Medical Assistance* Programs Who Received Any Dental Service, Rhode Island, Federal Fiscal Years 2003-2009 100% 90% 80% 70% 60% 51% 50% 41% 40% 30% 20% 10% 0% 2003 2004 2005 2006 2007 2008 2009 Source: Rhode Island Department of Human Services, Federal Fiscal Years 2003-2009. *Medical Assistance includes RIte Care, RIte Share or Medicaid fee-for-service. ◆ Half (51%) of the children who were enrolled in RIte Care, RIte Share or Medicaid fee-for-service on September 30, 2009 received a dental service during Federal Fiscal Year 2009. 16 The Centers for Medicare and Medicaid Services (CMS) reports that Rhode Island ranked 6th best in the U.S. for the percentage of children under age 21 enrolled in Medicaid who received dental services in Federal Fiscal Year 2008. 17 ◆ The increase in access to dental care for low-income children has been attributed to the RIte Smiles program, Rhode Island’s dental benefits management program for young children (who were born on or after May 1, 2000). 18,19 As of December 31, 2009, there were 45,684 Rhode Island children receiving dental benefits through the RIte Smiles program. At the end of 2009, there were 276 dental providers participating in the RIte Smiles program, up from 90 when it began in September 2006. All children receiving Medical Assistance who were born before May 1, 2000 continue to receive dental benefits under the fee-for-service system. 20 ◆ The federal Medicaid program mandates that states provide comprehensive dental services, including diagnostic and preventive services, treatment services, emergency services, and medically necessary orthodontic services to eligible children up to age 21. 21 ◆ Dental insurance is not available to many working families in Rhode Island. In 2007, half (50%) of Rhode Island employers reported offering dental insurance to their fulltime employees, and 9% offered it to their part-time employees (compared to 79% and 10% who offer health insurance, respectively). 22 2003 2007 56 2010 Rhode Island KIDS COUNT Factbook / Health
Page 1 and 2:
2010 Rhode Island Kids Count Factbo
Page 3 and 4:
Rhode Island KIDS COUNT Board of Di
Page 5 and 6: Overview From: I’ll Be You and Yo
Page 7: Family and Community From: On Freed
Page 10 and 11: Table 1. Child Population, Rhode Is
Page 12 and 13: Children in Single-Parent Families
Page 14 and 15: Table 3. Grandparents Caring for Gr
Page 16 and 17: Infants Born at Highest Risk Table
Page 18 and 19: Table 5. Births by Education Level
Page 20 and 21: Racial and Ethnic Diversity Table 6
Page 22 and 23: Racial and Ethnic Disparities Econo
Page 24 and 25: Racial and Ethnic Disparities Rhode
Page 27 and 28: 600 Median Family Income DEFINITION
Page 29 and 30: Cost of Housing 1300 1200 1100 DEFI
Page 31 and 32: Homeless Children DEFINITION Homele
Page 33 and 34: Secure Parental Employment DEFINITI
Page 35 and 36: Children Receiving Child Support DE
Page 37 and 38: 35 Children in Poverty DEFINITION C
Page 39 and 40: Children in Poverty Financial Asset
Page 41 and 42: 2000 Children in Families Receiving
Page 43 and 44: Children in Families Receiving Cash
Page 45 and 46: Children Receiving SNAP Benefits 75
Page 47 and 48: Women and Children Participating in
Page 49 and 50: 50 Children Participating in School
Page 51: Health Make Music with Your Life by
Page 54 and 55: Children’s Health Insurance Table
Page 58 and 59: Access to Dental Care Oral Health S
Page 60 and 61: Children’s Mental Health Referenc
Page 62 and 63: Children with Special Needs Medical
Page 64 and 65: Table 17. Breastfeeding Rates, Rhod
Page 66 and 67: Women with Delayed Prenatal Care Ta
Page 68 and 69: Preterm Births Table 19. Preterm Bi
Page 70 and 71: Table 20. Low Birthweight Infants,
Page 72 and 73: Infant Mortality Table 21. Infant M
Page 74 and 75: Table 22. Lead Poisoning in Childre
Page 76 and 77: Table 23. Asthma Hospitalizations f
Page 78 and 79: Housing and Health Key Principles o
Page 80 and 81: 20 15 Childhood Obesity 10 20% 15%
Page 82 and 83: Table 24. Births to Teens, Ages 15-
Page 84 and 85: Alcohol, Drug and Cigarette Use by
Page 87 and 88: 30 Child Deaths DEFINITION Child de
Page 89 and 90: Youth Violence DEFINITION Youth vio
Page 91 and 92: Disconnected Youth DEFINITION Disco
Page 93 and 94: Juveniles Referred to Family Court
Page 95 and 96: Juveniles at the Training School DE
Page 97 and 98: Juveniles at the Training School Gi
Page 99 and 100: Children of Incarcerated Parents DE
Page 101 and 102: Children Witnessing Domestic Violen
Page 103 and 104: Child Abuse and Neglect DEFINITION
Page 105 and 106: Child Abuse and Neglect Indicated A
Page 107 and 108:
Children in Out-of-Home Placement D
Page 109 and 110:
Permanency for Children in DCYF Car
Page 111:
Child of the Sun by Lillian M. Fish
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Table 31. Rhode Island Public Schoo
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Table 32. Infants and Toddlers Enro
Page 118 and 119:
Table 33. Children Ages Birth to Th
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Infant and Preschool Child Care Tab
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Table 35. Measuring Quality in Earl
Page 124 and 125:
Children Enrolled in Head Start Tab
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Full-Day Kindergarten Table 37. Chi
Page 128 and 129:
Children Receiving Child Care Subsi
Page 130 and 131:
Federal Financing After-School Care
Page 132 and 133:
English Language Learners Table 40.
Page 134 and 135:
Table 41. Kindergarten Through 12th
Page 136 and 137:
Table 42. Student Mobility and Stab
Page 138 and 139:
Fourth-Grade Reading Skills Table 4
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Eighth-Grade Reading Skills Table 4
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Table 45. Fourth and Eighth Grade M
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Schools Making Insufficient Progres
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Chronic Early Absence Table 47. Chr
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School Attendance Table 48. Student
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Table 49. Disciplinary Actions, Rho
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High School Graduation Rate Table 5
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College Preparation and Access Tabl
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Teens Not in School and Not Working
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Methodology The 2010 Rhode Island K
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Methodology & References Family Inc
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References 6 U.S. Census Bureau, Am
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References 13,15 Rhode Island Depar
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References (continued from page 63)
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References 15 U.S. Department of He
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References RICHIST, 2009. 29 Safety
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References 16,21 Chang, H. N. & Agu
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Rhode Island KIDS COUNT Committees
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Acknowledgements The 2010 Rhode Isl
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Acknowledgements Michael Burk, RI D
Page 180:
Notes 180 2010 Rhode Island KIDS CO
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2010 Rhode Island Kids Count Factbook

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