Kansas ranks tenth overall among states and the District of Columbia in child health care, according to a report released this week by the Commonwealth Fund. The report, “U.S. Variations in Child Health System Performance: A State Scorecard,” evaluates five dimensions of state child health systems: access, quality, costs, potential to lead healthy lives, and equity.
“We are pleased that Kansas has received a high ranking for our efforts to provide for the health of children,” stated Roderick L. Bremby, Secretary of the Kansas Department of Health and Environment (KDHE). “Nevertheless, much work remains and we will continue to strive for better outcomes, particularly with regard to infant mortality rates; income, insurance and health disparities; and the potential for Kansas children to enjoy a life full of health.”
The state of Iowa received the number-one overall ranking, with Vermont, Maine, Massachusetts, New Hampshire and Ohio following. The report notes wide variations in health care access, quality, costs, equity and the potential for children to lead healthy lives within the U.S. Kansas rankings for selected indicators include:
· Kansas ranks seventh in the average family premium per enrolled
employee for employer-based health insurance in 2005. In contrast, Kansas is ranked 28th in personal health care spending per capita, at $5,382 per person in 2004.
· The state is ranked 13th in the percentage of children ages 19-35
months receiving all recommended doses of five key vaccines. In 2005, 83.8 percent of Kansas children had received all recommended doses.
· Kansas ranks 21st in the percentage of children ages 0-17 with both a medical and dental preventive care visit in the past year in 2003, at 60.7 percent.
· Kansas ranks 27th in its state infant mortality rate, with 7.2 deaths
per 1,000 live births in 2002 used as the report’s indicator. This is the same infant mortality rate reported by the state in 2006.
· For equity of child health care, Kansas receives a ranking of 30th.
This is based on rankings of 35th, 21st and 34th for the income equity, insurance coverage equity and race/ethnic equity indicators, respectively.
The report also ranked states by dimension of child health care, and provided general recommendations to all states on ways to improve. Kansas received the following dimension rankings:
· Access: 12 – The report points out the availability of Medicaid and
State Children Health Insurance Program (SCHIP) benefits as crucial for ensuring access to child health care, and considers numbers of low-income and overall children insured for evaluating that access. Adopting more generous eligibility criteria for SCHIP and making insurance coverage available that is designed to supplement that program are cited as possible measures that states and carriers could implement for improving access.
· Quality: 16 – Seven indicators, including vaccination rates and
preventive medical and dental care visits, are used to assess quality of child health care. The report highlights the importance of affordable access to care as an important first step for families to obtain essential care services as well as care that is well-coordinated and centered on the patient. The report further notes that children are more likely to get recommended preventive health care and have a medical home in states where more children are insured.
· Costs: 16 - State total personal health spending and family premiums
for employer-based health insurance are used as key indicators for measuring child health care costs. Health insurance premiums in the U.S. have risen considerably between 2001 and 2007; outpacing wage growth by 19 percent over the same period, according to the report. The report notes that differences in premium costs mostly reflect differences in health care and insurance costs rather than in benefits covered, but that states also regulate health insurance markets to differing degrees. The report further states, “Improving care and developing more efficient care systems have the potential to generate major savings.”
· Equity: 30 – This dimension measures differences in income, insurance status and race/ethnicity among populations within a state. The report suggests that states could mandate minimum benefits for all child health insurance, require child health plans to report on the quality of care, and make those reports available to families, providers and purchasers as ways to mitigate health disparities among low-income and minority families.
· Potential to Lead Healthy Lives: 23 – The report finds especially
pronounced regional differences in this dimension. The indicators used for evaluation include infant mortality and risk of childhood developmental delay. Obesity and poverty rates are noted as the primary risk factors affecting the health of children and families that contribute to the indicators used for measurement.
The Commonwealth Fund is a private foundation that promotes better access, improved quality, and greater efficiency in health care. For more information, visit www.commonwealthfund.org.