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Adolescent Well-Visit, 2019 Health Of Women And Children Report
Measure: Adolescent Well-Visit, 2019 Health Of Women And Children Report

Why does this matter?

While generally characterized by good health, adolescence is a transitional period in life with many unique challenges that require unique healthcare solutions. During this stage, adolescents experience rapid physical growth, changing hormones and sexual maturity. Social factors and behaviors that lead to morbidity and mortality are often initiated in adolescence, which makes it a critical time for education, prevention and early intervention.

According to the American Academy of Pediatrics, the benefits of annual adolescent well-visits include: 

  • Preventing illness through routine immunizations
  • Tracking growth and development
  • Discussing concerns about development, emotional well-being, risk reduction, behavior, sleep, and eating
  • Developing a trusting provider-patient relationship that fosters discussion of sensitive topics
Source:
  • U.S. HHS, HRSA, Maternal and Child Health Bureau (MCHB), Child and Adolescent Health Measurement Initiative (CAHMI), National Survey of Children's Health Indicator Data Set, Data Resource Center for Child and Adolescent Health, 2016-2017



Developmental Screening, 2019 Health Of Women And Children Report
Measure: Developmental Screening, 2019 Health Of Women And Children Report

Why does this matter?

Regular well-child visits with a health care provider are an integral part of promoting healthy growth and development of children. During these visits, doctors monitor and screen for delays or problems in the child’s development. These screenings can lead to early detection of developmental disabilities, which can then lead to better treatments and improved outcomes in adulthood for children with autism or attention deficit hyperactivity disorder (ADHD). A delay in detection of developmental disorders is a missed opportunity to provide services and interventions that reduce costs and burdens associated with developmental disorders.

Source:
  • National Survey of Children's Health, U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), 2016-2017



HPV Female, 2019 Health Of Women And Children Report
Measure: HPV Immunization - Females, 2019 Health Of Women And Children Report

Why does this matter?

Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting nearly all sexually active men and women in the United States. Almost 80 million Americans, or about one in four, are infected with HPV, and about 14 million people become newly infected each year. HPV can spread even if the infected person has no signs or symptoms. HPV infections can cause different types of cancer as well as genital warts. In fact, most cases of cervical cancer, cancers of the anus, cancers of the throat, cancers of the vagina and vulva and cases of genital warts are associated with HPV infection.

The HPV vaccine is the first vaccine ever developed against cancer. Three HPV vaccines have been approved by the U.S. Food and Drug Administration (FDA) for use in the United States since 2006. Recent studies, however, have shown the newest FDA-approved vaccine, 9-valent human HPV vaccine, to be more cost effective than previous HPV vaccines and therefore it is now the only vaccine available in the United States. HPV-associated diseases cause the United States an estimated $8 billion (2010 dollars) in annual direct medical costs for prevention and treatment of all HPV types.

Source:
  • CDC, National Immunization Survey-Teen, 2017



HPV Male, 2019 Health Of Women And Children Report
Measure: HPV Immunization - Males, 2019 Health Of Women And Children Report

Why does this matter?

Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting nearly all sexually active men and women in the United States. Almost 80 million Americans, or about one in four, are infected with HPV, and about 14 million people become newly infected each year. HPV can spread even if the infected person has no signs or symptoms. HPV infections can cause different types of cancer as well as genital warts. In fact, most cases of cervical cancer, cancers of the anus, cancers of the throat, cancers of the vagina and vulva and cases of genital warts are associated with HPV infection.

The HPV vaccine is the first vaccine ever developed against cancer. Three HPV vaccines have been approved by the U.S. Food and Drug Administration (FDA) for use in the United States since 2006. Recent studies, however, have shown the newest FDA-approved vaccine, 9-valent human HPV vaccine, to be more cost effective than previous HPV vaccines and therefore it is now the only vaccine available in the United States. HPV-associated diseases cause the United States. an estimated $8 billion (2010 dollars) in annual direct medical costs for prevention and treatment of all HPV types.

Initial HPV vaccine trials were conducted on females, resulting in a three-year delay between when boys were first offered the vaccine versus girls. Adolescent boys have a lower prevalence of being up to date on the HPV vaccine than adolescent girls. It is important for boys to get vaccinated. Every year in the United States, more than 13,000 men will get cancers caused by HPV infections.

Source:
  • CDC, National Immunization Survey-Teen, 2017



Meningococcal, 2019 Health Of Women And Children Report
Measure: Meningococcal Immunizations, 2019 Health Of Women And Children Report

Why does this matter?

Meningococcal disease is a potentially life-threatening illness caused by the bacterium Neisseria meningitidis. It is a leading cause of bacterial meningitis in the United States. At any given time, about 10 percent of the U.S. population are carriers of N. meningitidis, meaning the bacteria are living in the nose and throat without causing disease. The bacteria can spread when people have close or lengthy contact with another person’s respiratory secretions, such as through kissing, coughing or living in the same household.

Five serogroups (A, B, C, W and Y) cause most meningococcal disease cases in the United States. Preventing the disease remains a priority because of the potentially serious outcomes and risk of outbreaks. There were around 350 cases reported in 2017, with the highest incidence occurring among infants.

The Centers for Disease Control and Prevention recommends that all preteens ages 11 and 12 get the meningococcal conjugate vaccine (covers the A, C, W and Y serogroups), with a booster at age 16. Teens may also get the optional serogroup B meningococcal disease for further protection. An analysis of the effectiveness of adolescent meningococcal vaccination found that getting one dose of the vaccine at age 11 and a booster at age 16 was cost-effective and prevented the most numbers of disease cases and deaths.

Source:
  • CDC, National Immunization Survey-Teen, 2017



Tdap, 2019 Health Of Women And Children Report
Measure: Tdap Immunizations, 2019 Health Of Women And Children Report

Why does this matter?

Tetanus, diphtheria and pertussis are serious illnesses that are caused by bacteria. Vaccination is the most effective defense against illness and death from these diseases.

  • Tetanus (lockjaw) causes painful muscle tightening, stiffness and difficulty breathing.
  • Diphtheria can cause a thick coating to form in the throat, making it hard to breathe and swallow. It can also cause heart failure, paralysis and death
  • Pertussis (whooping cough) is an acute respiratory infection causing severe and prolonged coughing, potentially progressing to pneumonia or even death

Diphtheria and pertussis are spread through person-to-person contact, mainly via respiratory and throat secretions. Tetanus is non-communicable and enters the body through cuts, scratches and wounds.

The childhood vaccine for these diseases is called DTaP (diphtheria and tetanus toxoids and acellular pertussis vaccine) and the booster vaccine for adolescents and adults is called Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine). The Tdap vaccine is recommended for:

  • Adolescents ages 11-18 (preferably at age 11 or 12) who have completed the recommended childhood DTaP series
  • Adults aged 19 and older who have not previously received a dose of Tdap 
  • Anyone who has close contact with infants or has not previously received Tdap
  • Pregnant women, in order to protect newborns from pertussis — infants are most at risk for severe, life-threatening illness from pertussis

Since vaccination began in the United States, reported tetanus and diphtheria cases have dropped 99 percent, and reported pertussis cases dropped 80 percent. In 2017, there were 18,975 reported cases of pertussis in the United States.

A recent literature review found that pertussis vaccination among adolescents is cost-effective. Tdap vaccination during pregnancy has also been found to be a highly cost-effective intervention that provides infants with protection against pertussis.

Source:
  • CDC, National Immunization Survey-Teen, 2017



Immunizations - Children, 2019 Health Of Women And Children Report
Measure: Immunizations - Children, 2019 Health Of Women And Children Report

Why does this matter?

Early childhood immunization is a safe and cost-effective way of protecting infants and children from potentially life-threatening preventable diseases early in life when they are most vulnerable. Infants receiving recommended immunizations by age 2 are protected from 14 diseases. Vaccinations have led to a 95% decrease in vaccine-preventable diseases in the past 50 years, leading the Centers for Disease Control and Prevention (CDC) to call vaccines one of the 10 greatest public health achievements of the 20th century.

After implementation of the Vaccines For Children Program in 1994, modeling estimated that among all children born between 1994 and 2013, childhood vaccinations would prevent 322 million cases of disease and 21 million hospitalizations over their lifetimes, and prevent 732,000 premature deaths due to vaccine preventable diseases. These estimates translate to net savings of $295 billion in direct costs and $1.38 trillion in total societal costs.

Source:
  • CDC, National Immunization Survey-Child, 2017



Medical Home for Child With Special Health Care Needs, 2019 Health Of Women And Children Report
Measure: Medical Home for Child With Special Health Care Needs, 2019 Health Of Women And Children Report

Why does this matter?

The Maternal and Child Health Bureau (MCHB) recommends that children with special health care needs receive care within a medical home.

Children with special health care needs

The accepted definition of children with special health care needs, as stated by  McPherson et al., are those “who have or are at increased risk of chronic physical, developmental, behavioral or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.” In 2017, 18.2 percent of United States children ages 0-17 had a special health care need.

Medical home

The medical home model was developed by the American Academy of Pediatrics to promote information exchange, improve quality of care and minimize gaps in care that often lead to poor outcomes, decreased patient satisfaction and higher costs.

In 2017, 43.2 percent of U.S. children ages 0-17 with special health care needs received care within a medical home. The Child and Adolescent Health Measurement Initiative, which was developed using data from the National Survey of Children's Health, measures the presence of a medical home by the following five criteria:

  • Having a personal doctor or nurse
  • Having a usual source of sick care other than a hospital emergency room
  • Having family-centered care
  • Not having problems getting needed referrals
  • Having effective care coordination when needed

Children with special health care needs who receive care in a medical home model experience better outcomes than children receiving care in non-medical home settings. Children with special health care needs without a medical home, compared with children with special health care needs with a medical home, had 2.3 times the odds to have delayed or forgone care,  2.5 times the odds to have unmet health care needs and 4.3 times the odds to have unmet needs for family support.

Source:
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