Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.

May 8, 2009

1. SURVEY BRINGS PUBLIC'S VIEWS INTO HEALTH CARE REFORM DISCUSSION

The Public and the Health Care Delivery System highlights survey findings on the public's attitudes and experiences with the American health care delivery system as well as the public's views on possible policy changes. Representatives of National Public Radio, the Henry J. Kaiser Family Foundation, and the Harvard School of Public Health developed the survey questionnaire and analyzed the results. The survey was conducted by telephone on March 12-22, 2009, among a nationally representative sample of 1,238 selected respondents ages 18 and older to shed light on issues that health policy analysts more typically discuss. All of these issues have become components of health care reform plans, and some have recently been signed into law. Topics include electronic medical records, coordination of care, overtreatment and undertreatment, patient and doctor interactions related to effectiveness and cost, the role of government and insurers in cost and comparative effectiveness, the cost of care, and the uninsured and cost. The full survey is available at http://www.kff.org/kaiserpolls/upload/7888.pdf. The summary and chartpack are available at http://www.kff.org/kaiserpolls/upload/7887.pdf.

• Offspring of women ages 35 and older were more likely to have ASD, compared with offspring of women ages 20-34 (OR = 1.68).
• After controlling for maternal age and gestational age, children with ASD were also more likely (OR=1.79) than their birth cohorts without ASD to be the first born.
• Analyses showed no association between risk for ASD and paternal age, years of paternal education, smoking, or gestational age.
• Children with ASD were more likely than their counterparts without ASD to have had a breech presentation and to have been born by cesarean delivery (adjusted OR=2.10). The significance of primary cesarean delivery was lost when excluding children who presented breech (an indication for performing cesarean delivery).
• There was no increased risk for ASD associated with uterine hemorrhage, fetal distress, or secondary cesarean delivery.
• Birthweight, congenital anomalies, assisted ventilation for more than 30 minutes, and 5-minute Apgar scores were also not associated with increased risk for ASD.

• The predominant race of children in Head Start centers was black (49.2 percent) followed by white (33.8 percent). In non-Head Start centers, the predominant race was white (56.2 percent) followed by black (29.6 percent).
• Overall, about one-third of the study children received some form of public assistance (e.g., Medicaid).
• Directors of Head Start centers were more likely than directors of non-Head Start centers to consult health professionals, particularly dieticians (50.6 percent vs. 15.5 percent) and mental health consultants (60.2 percent vs. 16.3 percent).
• More than 90 percent of Head Start centers screened for child health problems, compared with 64.9 percent of non-Head Start centers.
• Almost all (98.4 percent) of Head Start centers provided parents with child health information, compared to 91.6 percent of non-Head Start centers.
• Even after adjusting for race and public assistance, children who attended Head Start centers were perceived to be at greater risk for oral health problems than those who attended non-Head Start centers.
• Less than 3 percent of Head Start center directors, compared with 11.3 percent of non-Head Start center directors, reported that children watched TV for more than an hour during a "typical day" at their center.
• Rates of other health concerns (e.g., behavioral and developmental issues) and reported barriers to parents' health education were similar for Head Start and non-Head Start centers.