Texas KIDS COUNT: Our Border, Our Future May 8, 2009 La Fe Cultural & Technology Center El Paso, TX

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El Paso Hudspeth Jeff Davis Presidio Brewster Val Verde Culberson Kinney Maverick Zavala Dimmitt Webb Zapata Starr Jim Hogg Hidalgo Cameron Willacy Brooks Terrell TX Counties Along the Border with Mexico

One of Every Nine Kids Lives in Border Counties Source: Children ages 0-17, 2007 Population Estimates, Texas State Data Center; Urban designations from Texas Department of State Health Services, based on 2004 U.S. Office of Management and Budget definitions.

El Paso’s Child Population Growth Stagnant Since % 12% 2% 11% -4% Source: Children ages 0-17, 2007 Population Estimates, Texas State Data Center; Urban designations from Texas Department of State Health Services, based on 2004 U.S. Office of Management and Budget definitions. Border includes El Paso County.

Nearly One of Every Three El Paso Children Lives in an Immigrant Family; Virtually All Are Citizens Source: CPPP analysis of the citizenship and foreign-born data for 117 counties available in three-year American Community Survey Data. Border includes El Paso County.

Median Household Income in Urban Border Counties Lower than Even Rural Non-border Counties Source: CPPP analysis of 2007 Median Household Income from Small Area Income and Poverty Estimates & Households from Census 2000 Summary File 3. Border includes El Paso County.

El Paso also Experiences Purchasing Power Plateau Source: CPPP analysis using 2007 Median Household Income from Small Area Income and Poverty Estimates. Purchasing Power = Median Income adjusted for inflation to year 2000 dollars.

Although Better than in 2000, Border Unemployment Still Much Higher Than Rest of State Source: CPPP of Texas Workforce Commission unemployment and labor market data. Border includes El Paso County.

Child Poverty in Texas Heavily Concentrated Along the Border; More Than One of Every Three El Paso Children Live in Poverty El Paso County (37.9%) Source: 2006 Small Area Income and Poverty Estimates, U.S. Census Bureau

2009 Federal Poverty Guidelines Persons in familyPoverty guideline 1$10, , , , ,790 Source: U.S. Department of Health and Human Services

Kids Living on Border More Than Twice as Likely to Live in Poverty Source: Small Area Income and Poverty Estimates, U.S. Census Bureau. Border includes El Paso County.

Children in Immigrant Families on Border Much More Likely to Live in Poverty Source: CPPP analysis of poverty and foreign-born data for 117 counties available in three-year American Community Survey data. Border includes El Paso County.

Infant Health

One of Every Seven Texas Babies is Born in a Border County Source: Texas Department of State Health Services 2005 birth data

Infant Mortality Program Review/Planning Tool Age at Death FetalNeonatal (< 28 days old) Post Neonatal (>= 28 days old) Birthweight< 2500gMaternal Health and Prematurity >= 2500 gMaternal Care Newborn CareInfant Health and Safety Source: Adapted from presentation on March 27, 2009 by Brian Castrucci, Director of the Office of Program Decision Support at the Division of Family and Community Health Services with the Department of State Health Services.

Border Counties’ Infant Mortality Rates Lower Than Rest of State, but Show the Same Pattern Source: CPPP analysis of Texas Department of State Health Services 2005 death and birth data. Border includes El Paso County.

Largest Number of El Paso County’s Infant Mortalities Occurring within First Month with Very Low Birthweight Babies Source: 2005 death data, Texas Department of State Health Services

Reducing El Paso County’s Infant Mortality Rate Will Require Increased Attention to Maternal Health and Prematurity Age at Death FetalNeonatal (< 28 days old) Post Neonatal (>= 28 days old) Birthweight< 2500gMaternal Health and Prematurity >= 2500 gMaternal Care Newborn CareInfant Health and Safety Source: Adapted from presentation on March 27, 2009 by Brian Castrucci, Director of the Office of Program Decision Support at the Division of Family and Community Health Services with the Department of State Health Services.

Women Living in the Urban Border Counties More Likely to Have Inadequate Prenatal Care Source: Texas Department of State Health Services. Border includes El Paso County. Inadequate Prenatal Care = No prenatal care or care that begins after first trimester.

At Most Education Levels, Women Along the Border More Likely to Receive Inadequate Prenatal Care Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Border includes El Paso County. Inadequate Prenatal Care = No prenatal care or care that begins after first trimester.

One of Every Three Births in El Paso County to Mother with Less than High School Degree Source: CPPP analysis of Texas Department of State Health Services 2005 birth data.

The Percentage of Low Birthweight Babies (< 2500g) Born in Border Counties Slightly Lower than Rest of State; El Paso Slightly Higher Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Urban Border data includes El Paso County.

Majority of Low Birthweight Births are Linked to Preterm Deliveries Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Urban Border data includes El Paso County.

One in Five Babies Born in Rural Border Counties is to a Teen Mom Ages Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Urban Border data includes El Paso County.

Of the More Than 2,300 Births to Teens in El Paso, One in Five were to Teens Who Were Already Mothers Source: CPPP analysis of Texas Department of State Health Services 2005 birth data.

Health Care Coverage and Access

TX Border Counties Projected to Have Some of the Highest Rates of Uninsured Children in 2010 Percentage of Uninsured Children Source: Texas State Data Center, Uninsured projections for children 0-17 in El Paso County (25.4%)

Higher Child Medicaid Enrollment Along Border Percentage of Children on Medicaid Source: CPPP analysis of Texas Health and Human Services Commission data: All Children ages 0-18 enrolled in Medicaid in August 2007 as a percentage of total 2007 child population 0-18 El Paso County (39.3%)

The Number of El Paso Children on Medicaid Increased After Instituting Six-Month Continuous Enrollment in 2002; Later Decline Due to Eligibility System Breakdown Beginning in 2006 Simplified Enrollment Begins Source: Texas Health and Human Services Commission

Majority of Doctors Serving Children and Families have Medicaid Clients Source: CPPP analysis of Texas Health and Human Services Commission 2007 Medicaid claim data and 2008 Physician Licensure Data

Texas Border Counties Have Fewer Doctors to Serve Children and Families Than the Rest of the State Source: CPPP analysis of Texas Department of State Health Services 2008 data.

Physician Acceptance of New Medicaid Patients in Texas, 2008 Source: Texas Medical Association based on TMA Physician Survey Prepared by TMA, 2008.

Texas Voice for Health Reform El Paso, TX May 8, 2009 Kymberlie Quong Charles, Coordinator

Texas Voice for Health Reform

The Government and the American People Agree… "The status quo is the one option that is not on the table," he said. "And those who seek to block any reform at any cost will not prevail this time around." -- President Barak Obama, Christian Science Monitor, March 6, 2009 Does our health care system need complete overhaul, major reform, minor reform or no reform at all? Voter attitudes on Health System Change Reforms: Findings from a Survey of 800 Likely Voters Nationwide, Lake Research Partners, April 20, %

“The crucial and weighty step needed is the decision as a country to ensure access to health care as a public good, just as we do education, roads, military, fire, and police protection.” -- Anne Dunkelberg, Associate Director, Center for Public Policy Priorities

Texas Voice for Health Reform Principles Affordability Accessibility Quality

Affordable access to good healthcare must be available for all Americans. It should: Cover all who want it Be affordable for people at all income levels Remain available and affordable when family and economic circumstances change Establish both a responsibility for the public to contribute and an assurance of cost containment for individuals and families Eliminate health costs as the number one cause of bankruptcy in the United States.

A decent standard of comprehensive care must be established. It should: Keep people healthy and treat them when they’re ill Cover the whole person Not be lost or reduced based on pre-existing conditions or pregnancy

Additionally, in order to be effective, sustainable, equitable, and balanced with our other important priorities as a nation, national health reform should also address: Safe and high quality care Costs and Cost-Effectiveness of Healthcare Consumer Choice Eliminating barriers to and disparities in care

Get Involved Join our list Communicate with us about your healthcare priorities How do our principles fit with your priorities? Contribute to our Story Bank project Engage in citizen advocacy using our online resources

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Contact Information Frances Deviney, PhD Texas KIDS COUNT Director (512) ext. 106 Kymberlie Quong Charles Texas Voice for Health Reform (512) ext. 115