Child Health Child Health- 1
Child Health I ngham County child health data is presented in this section. The data in this section includes information on weight, hospitalizations, and the State of Michigan s Michigan Profile of Healthy Youth. This information can be used for health service planning and to help understand the health status of children in the community. Child Health Hospitalizations Ambulatory Care Sensitive (ACS) Hospitalizations Childhood Obesity Tobacco & Alcohol Use Bullying Child Health - 2
Hospitalizations O ne of the most reliable forms of data about child health is hospitalization data. Hospital discharge data for shortstay hospitals (including Veterans Administration hospitals, but not military hospitals). These hospitalizations are from the Michigan Resident Inpatient files, which accounted for approximately 1.25 million hospitalizations annually. Hospitalizations are inpatient hospital stays as measured by stays that were completed during the specified year. Consequently, the number of hospitalizations can be greater than the number of persons hospitalized since some persons are hospitalized more than once during the year. Table 1. Leading Diagnoses for Hospitalizations Patients Under 18 Years of Age in Ingham County Residents, 2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC). Child Health- 3
Hospitalizations Figure 2. Number of Hospitalizations for the Top 20 Leading Diagnoses for Ingham Patients Under 18 Years of Age in Ingham County Residents, 2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health - 4
Hospitalizations Figure 3. Rate per 10,000 Population of Hospitalizations for the Top 20 Leading Diagnoses for Patients Under 18 Years of Age in Ingham County Residents, 2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health- 5
Hospitalizations Table 2. Hospitalizations and Rates per 10,000 Population For Twenty Statewide Leading Diagnoses for Patients Under 18 Years of Age in Ingham County Residents, 2009-2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health - 6
Hospitalizations Figure 3. Number of Hospitalizations for the Top 20 Leading Diagnoses for Ingham Patients Under 18 Years of Age in Ingham County Residents, 2009-2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health- 7
Hospitalizations Figure 4. Rate per 10,000 populations of Hospitalizations for the Top 20 Leading Diagnoses for Patients Under 18 Years of Age in Ingham County Residents, 2009-2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health - 8
Hospitalizations > ACS A mbulatory Care Sensitive (ACS) hospitalizations are preventable hospitalizations. Conditions like asthma, diabetes or dehydration ought not to cause a hospitalization if properly managed (i.e. controlling an acute episode of an illness or managing a chronic disease or condition.). Consequently, high rates of ACS hospitalizations may be an indicator of a lack of or failure of prevention efforts, a primary care resource shortage, poor performance of primary health care delivery systems, or other factors that create barriers to obtaining timely and effective care. Table 3. Ten Leading Causes of Ambulatory Care Sensitive Hospitalizations for Patients Under 18 Years of Age in Ingham County Residents, 2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health- 9
Hospitalizations > ACS Figure 5. Ten Leading Causes of Ambulatory Care Sensitive Hospitalizations for Patients Under 18 Years of Age in Ingham County Residents, 2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health - 10
Hospitalizations > ACS Figure 6. Percent of the Ten Leading Causes of Ambulatory Care Sensitive Hospitalizations for Patients Under 18 Years of Age in Ingham County Residents, 2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health- 11
Hospitalizations > ACS Table 4. Ambulatory Care Sensitive Hospitalizations and Rates per 10,000 Population For Patients Under 18 Years of Age by Statewide Leading Diagnoses for Ingham County Residents, 2009-2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health - 12
Hospitalizations > ACS Figure 7. Ten Leading Causes of Ambulatory Care Sensitive Hospitalizations for Patients Under 18 Years of Age in Ingham County Residents, 2009-2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health- 13
Hospitalizations > ACS Figure 8. Rate per 10,000 of the Ten Leading Causes of Ambulatory Care Sensitive Hospitalizations for Patients Under 18 Years of Age in Ingham County Residents, 2009-2014 Source: Michigan Resident Inpatient Files created by the Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services, using data from the Michigan Inpatient Database obtained with permission from the Michigan Health & Hospital Association Service Corporation (MHASC), 2014. Child Health - 14
Childhood Obesity C hildhood obesity is a health issue. Obesity in children is determined by using Body Mass Index (BMI)-for-age percentiles. A child is defined as obese if their body mass index-for-age (or BMI-for-age) percentile is greater than 95 percent. A child is defined as overweight if their BMI-for-age percentile is between the 85th and 95th percentile. Children who are considered affected by obesity are 70% more likely to continue being affected by obesity into adulthood. In addition, they are at greater risk for serious medical issues such as: heart disease; high cholesterol; high blood pressure; diabetes; sleep apnea; and cancer. In addition to physical consequences, children who are affected by obesity face psychosocial consequences including social discrimination, low self-esteem, and depression. Two non-population-based sources of information for childhood weight status in Ingham County are the Pediatric Nutrition Surveillance System and the Michigan Profile for Healthy Youth. The Pediatric Nutrition Surveillance System (PedNSS) is a public health surveillance system that reports on the nutritional status of low-income infants and children who are enrolled in federally funded maternal and child health nutrition programs. In Michigan, PedNSS data consist of data from clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC clients demographic, behavioral, and health information are collected during client certification/recertification visits. Other data collected from the client includes anthropomorphic measurements (i.e., height, weight, and birthweight), clinical nutritional indicators status (i.e., hematology measurements), and breastfeeding practices. Because this data is only collected from WIC clients, it is not generalizable to children throughout Ingham County. The Michigan Profile for Healthy Youth (MiPHY) is an online survey administered by the Michigan Department of Education and Health and Human Services that is designed to support local and regional needs assessment. The survey measures health risk behaviors and risk and protective factors in grades 7th, 9th, and 11th. The topics covered in the survey include substance use, physical activity, nutrition, sexual behavior, emotional health, and violence. Because the Mi- PHY is an online survey, it is not generalizable to all 7th, 9th, and 11th grade students in Michigan. Child Health- 15
Childhood Obesity Table 5. Percent of Children Two to Five Years Old who are Overweight and Obese in Ingham County, 2011-2015 Source: Michigan Pediatric Nutrition Surveillance System, Michigan Department of Health and Human Services, 2011-2015 Figure 1. Percent of Children Two to Five Years Old who are Overweight and Obese in Ingham County, 2011-2015 Source: Michigan Pediatric Nutrition Surveillance System, Michigan Department of Health and Human Services, 2011-2015 Child Health - 16
Childhood Obesity Figure 9. Percentage of Ingham County Students Who are Considered Overweight (above 85th percentile and below the 95th percentile for BMI), Michigan Profile for Healthy Youth, 2015-2016 Source: State of Michigan, Michigan Department of Education, Michigan Profile for Healthy Youth, 2015-2016 Figure 10. Percentage of Ingham County Students Who Describe Themselves as Slightly or Very Overweight, Michigan Profile for Healthy Youth, 2015-2016 Source: State of Michigan, Michigan Department of Education, Michigan Profile for Healthy Youth, 2015-2016 Child Health- 17
Tobacco & Alcohol T obacco and alcohol are among the top causes of preventable deaths in the United States. 1 Although tobacco use by adolescents has declined substantially in the last 40 years, nearly one in 17 high school seniors was a daily smoker in 2015. 2 Moreover, these substances often are used together: Studies have found that people who smoke are much more likely to drink, and people who drink are much more likely to smoke. 3 Additionally people ages 14 18 typically start using tobacco and alcohol prior to other drugs 2 that is, they are considered gateway drugs. More adolescents drink alcohol than smoke cigarettes or use marijuana. 4 Youth who drink alcohol are more likely to experience: School, social, legal, and physical problems; Unwanted, unplanned, and unprotected sexual activity; Disruption of normal growth and sexual development; Physical and sexual assault; Higher risk for suicide and homicide; Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning; Memory problems; Abuse of other drugs; Changes in brain development that may have life-long effects; and Death from alcohol poisoning. 5,6,7 In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink. 8 Binge drinking is defined as: consuming 4 or more alcohol drinks (beer, wine, or liquor) on an occasion for women; and. consuming 5 or more alcohol drinks (beer, wine, or liquor) on an occasion for men. Adolescent use of e-cigarettes is becoming increasingly common. Tenth and 12th grade students who use e-cigarettes are eight and six times more likely, respectively, than their peers to smoke tobacco cigarettes. This suggests that youth who use e-cigarettes are likely to become tobacco cigarette smokers as they age. 8 Child Health - 18
Tobacco & Alcohol Figure 11. Percentage of Ingham County Students Who Used Any Tobacco (smoked cigarettes or cigars or used chewing tobacco, snuff, or dip) During the Past 30 Days, Michigan Profile for Healthy Youth, 2015-2016 Source: State of Michigan, Michigan Department of Education, Michigan Profile for Healthy Youth, 2015-2016 Figure 12. Percentage of Ingham County Students Who Used an Electronic Vapor Product During the Past 30 Days, Michigan Profile for Healthy Youth, 2015-2016 Source: State of Michigan, Michigan Department of Education, Michigan Profile for Healthy Youth, 2015-2016 Child Health- 19
Tobacco & Alcohol Figure 13. Percentage of Ingham County Students Who Had Five or More Drinks of Alcohol in a Row, That is, Within a Couple of Hours, During the Past 30 Days, Michigan Profile for Healthy Youth, 2015-2016 Source: State of Michigan, Michigan Department of Education, Michigan Profile for Healthy Youth, 2015-2016 Child Health - 20
Bullying B ullying is defined as repeated interpersonal behavior that is intended to do physical or psychological harm. 1 Bullying includes a wide variety of behaviors, but all involve a person or a group repeatedly trying to harm someone who is weaker or more vulnerable. It can involve direct attacks (such as hitting, threatening or intimidating, maliciously teasing and taunting, name-calling, making sexual remarks, and stealing or damaging belongings) or more subtle, indirect attacks (such as spreading rumors or encouraging others to reject or exclude someone). Kids who are bullied are more likely to experience: Depression and anxiety, increased feelings of sadness and loneliness, changes in sleep and eating patterns, and loss of interest in activities they used to enjoy. These issues may persist into adulthood. Health complaints Decreased academic achievement GPA and standardized test scores and school participation. They are more likely to miss, skip, or drop out of school. Kids who bully others can also engage in violent and other risky behaviors into adulthood. Kids who bully are more likely to: Abuse alcohol and other drugs in adolescence and as adults Get into fights, vandalize property, and drop out of school Engage in early sexual activity Have criminal convictions and traffic citations as adults Be abusive toward their romantic partners, spouses, or children as adults Figure 14. Percentage of Ingham County Students Who Have Been Bullied on School Property in the Past 12 Months, Michigan Profile for Healthy Youth, 2015-2016 Source: State of Michigan, Michigan Department of Education, Michigan Profile for Healthy Youth, 2015-2016 1. Child Trends Databank (2009). Bullying. Available at http:// www.childtrendsdatabank.org/?q=node/370 Child Health- 21
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