RESUMEN
METHODS: Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion. RESULTS: No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC). CONCLUSION: The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.
Asunto(s)
Discapacidades para el Aprendizaje/diagnóstico , Tamizaje Masivo/legislación & jurisprudencia , Asma/complicaciones , Asma/diagnóstico , Niño , Femenino , Trastornos de la Audición/complicaciones , Trastornos de la Audición/diagnóstico , Humanos , Discapacidades para el Aprendizaje/etiología , Masculino , Trastornos Mentales/complicaciones , Trastornos Mentales/diagnóstico , Odontalgia/complicaciones , Odontalgia/diagnóstico , Trastornos de la Visión/complicaciones , Trastornos de la Visión/diagnósticoRESUMEN
Family homelessness emerged as a major social and public health problem in the United States during the 1980s. We reviewed the literature, including journal articles, news stories, and government reports, that described conditions associated with family homelessness, the scope of the problem, and the health and mental health of homeless children and families. Much of this literature was published during the 1980s and 1990s. This raises questions about its continued applicability for the public health community. We concluded that descriptions of the economic conditions and public policies associated with family homelessness are still relevant; however, the homeless family population has changed over time. Family homelessness has become more prevalent and pervasive among poor and low-income families. We provide public health recommendations for these homeless families.
Asunto(s)
Familia , Estado de Salud , Personas con Mala Vivienda/estadística & datos numéricos , Salud Mental , Salud Pública , Niño , Dieta , Personas con Mala Vivienda/psicología , Jóvenes sin Hogar/psicología , Jóvenes sin Hogar/estadística & datos numéricos , Humanos , Pobreza/estadística & datos numéricos , Prevalencia , Estrés Psicológico/epidemiología , Estados Unidos/epidemiología , Poblaciones Vulnerables/estadística & datos numéricosRESUMEN
OBJECTIVE: To estimate savings to health care system of a best-practice asthma intervention in primary care for inner-city children. METHODS: Data were analyzed from National Heart, Lung and Blood Institute (NHLBI) Guidelines-based initial (n=244) and follow-up (n=202) asthma assessments of patients who received enhanced treatment in primary care. Savings were calculated using cost-of-illness model and compared with program cost. RESULTS: Patients were about equally distributed between African American and Hispanic children (mean age = 7 years; range 36 months-19 years). Of those with persistent asthma, 36% had been prescribed a controller medication. This significantly improved on follow-up (p<.01). There were significant reductions in asthma severity (p<.05) and emergency department use (p<.01), and near-significant reduction in asthma hospitalizations (p=.059). CONCLUSION: Total annual savings attributable to clinical outcomes was $4,202,813 or $4,525 per patient with asthma. Total annual cost of the implementation was $390,169 or $420 per asthma patient. Conservatively estimated savings exceeded cost of intervention by nearly 11 to 1.