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Children's health coverage is a major determinant of access to health care. Health affects every aspect of a child’s life, including the ability to grow, learn, play, and succeed in life. Good health is optimized when a child has an ongoing relationship with health providers, during times of sickness and health.
There are 7.9 million uninsured children in the United States. Millions more are underinsured. As a result, millions of children lack timely access to comprehensive health and mental health services, and must delay or forgo preventive care and treatment due to cost or other barriers.
Despite outspending all other countries in health care, the United States ranks among the lowest of industrialized nations on key indicators of the quality of child health and closely linked with health coverage. These indicators include pre-natal and infant health care, low birthweight rates, infant mortality, and child immunizations.
Ensuring that pregnant women have access to health care is critical to providing children with a healthy start in life. Health coverage for pregnant women encourages early and consistent prenatal care, which in turn is essential to ensure that newborns begin life in optimal health and have the best chance to stay in the best possible health through infancy, childhood, and into adulthood. While the importance of prenatal care is widely understood, too many women, especially those who are uninsured, receive only seriously delayed care or no prenatal care at all. More than 800,000 pregnant women are uninsured. Of the 4.1 million births in the United States in 2005, more than 750,000 were to women who were uninsured.
Low birthweight is a core risk factor for infant mortality and childhood developmental disorders, and remains persistently high in the United States, particularly relative to other industrialized nations. In 2006, the nation's incidence of low birthweight rose to 8.3 percent of all births that year, continuing the steady increase that began in 1985. The 2006 rate is 24 percent higher than the 1984 rate, matching the rate of 40 years earlier.
Take a state-by-state look at low birthweight rates.
While extraordinary progress has been made in the last half century in infant survival and health, the decline in infant mortality rates in the United States has not kept up with progress in other industrialized countries. According to the most recent data from UNICEF, the U.S. infant mortality rate ranked 27th among 30 industrialized countries. In fact, in 2002 our nation's infant mortality rate rose for the first time in more than 40 years; after declines in 2003 and 2004, the rate rose again in 2005, then declined again in 2006.
Immunization is one of the most effective ways to protect children from serious, preventable infectious diseases. In the United States, vaccination programs have rendered diseases such as rubella, diphtheria, and tetanus extremely rare, and have significantly reduced the incidence of measles. The creation of the Vaccines for Children (VFC) Program in 1993--which provides private health care providers with vaccines for uninsured children has contributed significantly to improving vaccination rates in a relatively short time.
Despite these improvements, one out of three Black two year olds—and one out of four Latino two year olds—have not been fully immunized. Making vaccines readily available to all children, regardless of income, is an effective model for improving the receipt of care and reducing or eliminating health disparities.
Our failure to protect access to health care for the most vulnerable among us affects all of us, regardless of our own family's coverage or financial well-being. Fortunately, this problem is solvable. Join CDF's Health Coverage for All Children Campaign in advocating for real health care reform for children in 2009.
i Institute of Medicine, Committee on Children, Health Insurance, and Access to Care. America's Children: Health Insurance and Access to Care. Washington DC: National Academy Press; 1998
ii U.S. Census Bureau, 2008 Annual Social and Economic Supplement to the Current Population Survey. Calculations by the Children's Defense Fund, October 2008.
iii Thompson L.A., Goodman D.C. et al. "Regional Variation in Rates of Low Birthweight" Pediatrics 2005; 116(5):1114-1121
iv U.S. Department of Health and Human Services, National Center for Health Statistics, National Vital Statistics Reports, Volume 57, Number 7 (January 7, 2009), Table 33; and U.S. Department of Health and Human Services, National Center for Health Statistics, Vital and Health Statistics, Series 21, No. 37 (April 1980), Table 1. Calculations by Children's Defense Fund.
v The State of the World's Children 2009. New York: The United Nations Children's Fund (UNICEF), Dcember 2008; Table 1: Basic Indicators. Ranking by the Children's Defense Fund, 2/09.
vi U.S. Department of Health and Human Services, National Center for Health Statistics, National Vital Statistics Reports, Vol. 57, No. 14 (April 17, 2009), Table 30; and U.S. Department of Health and Human Services, National Center for Health Statistics, Vital Statistics of the United States: 1968, Vol. II, Mortality, Part A (1972), Table 2-1.
vii Centers for Disease Control and Prevention. "Reported vaccine-preventable diseases – United States, 1993 and the Childhood Immunization Initiative." Morbidity and Mortality Weekly Report 43(4):57-60, February 4, 1994.