Infant Mortality Rates Stagnate
The infant mortality rate in the United States did not improve between 2000 and 2005, according to a report from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. The U.S. infant mortality rate was 6.86 per 1,000 live births in 2005, not statistically different from 6.89 in 2000. This 5-year period represents the first sustained time period without a drop in infant mortality since the 1950s. The lack of improvement is due in large part to an increase in the percentage of both very preterm and late preterm births and a lack of improvement in the infant mortality rate for very preterm infants, according to the CDC. However, preliminary data indicate there may have been a small decrease in infant mortality between 2005 and 2006, when the infant mortality rate dropped to 6.71. The United States also continues to rank near the bottom of industrialized countries in terms of infant mortality. The United States ranked 29th in the world on infant mortality based on 2004 data, down from a worldwide ranking of 12th in 1960 and 23rd in 1990.
New President-Elect for AAP
Dr. Judith S. Palfrey, the new president-elect of the American Academy of Pediatrics, said she intends to press hard for all children to have health coverage and a medical home with a physician who can coordinate their care. SCHIP reauthorization is necessary, but is not the complete answer to the problem of uninsured children, Dr. Palfrey told PEDIATRIC NEWS. “I mean full access, not incremental. My hope is that we can work toward full access to insurance for kids so we can have a medical home for every child.” Dr. Palfrey also expressed a desire to work for appropriate physician payment and for strong partnerships between AAP and other groups that are concerned with children's issues. Dr. Palfrey will serve as AAP president during 2009–2010.
Dental Disease Still Medicaid Issue
Dental disease remains a significant problem for children on Medicaid. National surveys taken between 1999 and 2004 show that about one in three had untreated tooth decay, with one in nine having untreated decay in three or more teeth, a Government Accountability Office study showed. The study estimated that in 2005, 6.5 million children aged 2–18 years had untreated tooth decay, and noted that children with Medicaid coverage were almost twice as likely to have untreated tooth decay as were children with private insurance. Meanwhile, the Agency for Healthcare Research and Quality noted in a separate report that enrollment in government-sponsored dental insurance programs has risen sharply in the past decade. About 30% of U.S. children had government-sponsored dental insurance in 2006, compared with 18% in 1996, the AHRQ said.
Behavioral Programs Help the Obese
Obese school-aged children and teenagers can lose weight or prevent further weight gain if they participate in medium- to high-intensity behavioral management programs, the AHRQ said in a report. Effective programs taught techniques to improve dietary and physical activity habits, with some using strategies like goal setting, problem solving, and relapse prevention. These programs met for a total of more than 25 hours, usually once or twice a week, for 6–12 months. Researchers found that, after completion of weight management programs, obese children would weigh 3–23 pounds less, on average, than those who were not involved in the programs. The weight difference was greatest among heavier children as well as those enrolled in more intensive programs, and weight improvements were maintained for up to 1 year after the program ended, the AHRQ study found.
New Jersey Mandates Flu Shots
New Jersey has become the first state to mandate that children aged 6 months to 5 years who attend day care or preschool receive both the influenza and the pneumococcal conjugate vaccine. Beginning this year, the federal Centers for Disease Control and Prevention has recommended that all children aged 5–18 years receive a flu shot each year, adding to its previous recommendation that children aged 6 months to 5 years receive the vaccine. But the New Jersey Public Health Council's decision late last year to require the vaccine for preschoolers and children in day care has drawn fire from some parents, who want to be able to choose whether their children receive vaccinations. Assemblywoman Charlotte Vandervalk (R-Bergen), a critic of mandatory vaccination, said that although New Jersey allows exceptions to mandatory vaccination for medical and religious grounds, few of these exceptions are actually granted. She is sponsoring legislation to allow for conscientious objections to mandatory vaccination.