Goal 1: Increase the number of children and pregnant women in good health Print E-mail

Goal 1: Increase the number of children and pregnant women in good health


For First 5 Humboldt, health means more than the physical body being free of disease. Health also includes emotional stability and a sense of well-being, positive connections to other people, and enough financial and other resources to meet physical, emotional, and social needs

Action: High quality, accessible prenatal care

Prenatal care Indicators:

  • % of births at normal birth weight
  • % women receiving early and adequate prenatal care
  • #/% of women who don’t use tobacco, alcohol and other drugs during pregnancy
  • #/% of pregnant teens

Synopsis of results related to prenatal care indicators: In 2015, 100% of the infants born to Paso a Paso clients and 95.6% of the infants born to Nurse Family Partnership (NFP) clients were at normal birth weight. In 2015, 73.3% of Paso a Paso clients received early prenatal care and 90% received adequate prenatal care. As of December 31, 2015, NFP assessed up to a total of 241 mothers at intake and at 36 weeks gestation for use of various substances. Of the mothers who stated they were smoking cigarettes, using marijuana and using cocaine at intake, there was a self-reported decrease in use at 36 weeks gestation. NFP enrollment data collected between July 1, 2009 and December 31, 2015, showed that 18.8% of the first time mothers were below 18 years of age and 27.9% were below 20 years.

Paso a Paso results related to prenatal care

Paso a Paso is a prenatal and family support program serving Latino families in Eureka and Fortuna. Services include childbirth classes, breastfeeding support groups, car seat classes, new parent classes, and Positive Discipline classes. Home visits are made both before and after the birth of the baby. During the period January-December 2015, staff made 206 home visits, down from 292 home visits the prior year.

 

 

Paso a Paso obtains information about the birth weights of the infants born to the clients they serve, as well as information about early and adequate prenatal care. The program reports that in 2015 the final postpartum visit was attended by 100% of their clients.

Nurse Family Partnership results related to prenatal care

Humboldt County’s Nurse Family Partnership (NFP) Program is an evidenced-based program that provides first time pregnant mothers with the support and care they need to have a healthy pregnancy. Each woman served by NFP is partnered with a registered nurse early in her pregnancy and receives ongoing nurse home visits that continue until the child’s second birthday. The program works with new mothers on getting prenatal care, improving diet, reducing drug/tobacco/alcohol use, improving child health and development by helping parents provide competent care, and improving economic self-sufficiency of the family. First 5 Humboldt began providing funding to the NFP in 2009.

In 2015, 90 new mothers were enrolled and 45 babies were born into the NFP program. Unduplicated counts for the year showed that NFP served 245 parents/caregivers and 200 children between the ages of 0-2. The number of opens cases at the end of 2015 was 106 mothers. Since July 2009, 118 families have completed the two and half year program. The most recent report data submitted by Humboldt County’s NFP showed a total of 519 first time mothers enrolled and 387 babies born between the start of the program in July 2009 and the end of 2015.

The percentage of the 45 infants born into NFP in 2015 at a birth weight of 2500 grams (5.5 pounds) or greater was 95.6%.

Regarding entry into prenatal care, 82.2% of the clients that were enrolled in the program between the start of the program in July 2009 and the end of 2015 had their initial prenatal visit in the first trimester of their pregnancy.

 

Nurse Family Partnership results related to use of tobacco, alcohol and other drugs during pregnancy

NFP reports clients’ maternal health habits related to substance use. From the beginning of the program to the end of 2015, up to 241 NFP clients were assessed via self-report for tobacco, alcohol, marijuana, cocaine and other drug use at intake and at 36 weeks gestation. The clients, who smoked cigarettes, smoked 5 or more cigarettes in the last 48 hours, used marijuana or used cocaine at intake, decreased their use at 36 weeks gestation. There was an increase of one client using alcohol between intake and 36 weeks gestation. In addition, there was an increase of one client using another type of drug between intake and 36 weeks gestation. See Table 1 below for more details.

Total Number of Clients Assessed Number of Clients Using at Intake Number of Clients Using @ 36 Weeks Pregnancy Percent Changed
Cigarette Smoker 232 34 29 -14.7%
Smoked 5+ Cigarettes in the last 48 hrs 232 18 15 -16.7%
Alcohol Use 241 2 3 50.0%
Marijuana Use 241 42 27 -35.7%
Cocaine Use 240 1 0 -100.0%
Other Drug Use 238 0 1 -

Table 1


 

Teen Pregnancy data for Humboldt County

Data collected from the Humboldt County Maternal Child and Adolescent Health Program showed that in 2015 there were 65 births to mothers between 15 -19 years of age. Humboldt County’s teen birth rate for 2015, defined as the number of live births per 1,000 females aged 15-19, was 16.4. These figures are considerably lower than those of 2014, 87 births to mothers between 15-19 years of age and a county teen birth rate of 21.6.

Nurse Family Partnership results related to teen pregnancy

The Nurse Family Partnership collects demographic data from first time mothers enrolling in the program. Intake data collected between July 1, 2009 and December 31, 2015, showed that 18.8% of the first time mothers were below 18 years of age and 27.9% were below 20 years of age.

Action: High-quality, accessible child health and dental care

Health access indicator:

  • #/% of children with health insurance

Synopsis of results related to health insurance indicator: Data from the Healthy Kids Humboldt program shows an increase in the total number of children ages 0-5 covered by Medi-Cal for the period 7/15-12/15, and the number covered by California Kids has increased from two to six. No data for Covered California was submitted. Data from First 5 Humboldt Participant Surveys, Playgroup Surveys, and unduplicated counts forms show that a slightly higher percentage of children in First 5 Humboldt funded programs had health insurance in 2015 than the previous year.

Healthy Kids Humboldt health insurance data

Data submitted by Healthy Kids Humboldt (HKH) was available for the period 7/15-12/15. The last data submitted prior to the 07/15-12/15 period covered 1/14-6/14. Data for Covered California, which replaced Healthy Families in 2013, is not available. A 2014 correspondence from Humboldt County Department of Health and Human Services regarding Covered California insurance data stated “Covered California is a private insurance coverage and not available to us.”

 

The number and percentage of California Kids enrollments of children ages 2-5 continues to remain low. From 7/15-12/15, a total of six children ages 2-5 were covered by California Kids. For the time period 1/14-6/14 (the only data provided for the year), as in 2013, only two children in Humboldt County aged 2-5 were enrolled in California Kids. In 2012, there were four children ages 2-5 enrolled. In 2011, thirteen children ages 2-5 were enrolled. In 2010, this figure was fourteen children age 2-5. In 2009, this figure was twenty-one. In 2008, twenty-eight children ages 2-5 were enrolled. Prior to 2008, numbers enrolled ranged from 35-42 children enrolled.

Staff at the Healthy Kids Humboldt Program directly assisted parents/caregivers of 190 children ages 0-5 in applying for/obtaining/maintaining health insurance for those children up from 167 in 2014. It is important to note that HKH has found that many families are still needing assistance with understanding the difference between Covered California and Medi-Cal.

First 5 Humboldt Participant Survey results related to health insurance coverage for 0-5 age children

According the 2015 Participant Survey, 91.9% of children participating in First 5 Humboldt funded programs had health insurance; this is up slightly from the 2014 Participant Survey results which show that 90.8% of children participating in First 5 Humboldt funded programs had health insurance. The 2013 California Health Interview Survey found that 98.3% of children age 0-5 in California had health insurance coverage. Current California and Humboldt County results as well as 2013 figures for Humboldt County were found to be statistically unstable.

 

Since 2006 health insurance coverage for children in First 5 programs has for the most part increased gradually, from 84.7% in 2006, to 91.9% in 2015.

 

First 5 Humboldt funded programs providing Parent and Family Support activities are asked to indicate on their “Unduplicated Counts” forms what health insurance product covers the children served by their programs. Seventeen programs asked to provide this information did provide it for some, though not all, of the children they served from July 2014 – June 2015. A minimum of 93% of children in these seventeen First 5 Humboldt Programs are covered by health insurance, up from 80.8% in fiscal year 2013-14.

Playgroup survey results related to health insurance

According to the 2015 Playgroup Survey, the percent of parents stating their child was covered by health insurance was 88.5%, an increase of 1.3% from 2014. Since 2009, health insurance coverage results for children in playgroups have ranged from 83.3% to 89.3%.

Child health indicators

  • % of parents reporting their children are in good/excellent health
  • #/% of children with up-to-date immunizations

Synopsis of results related to child health indicators: In the 2015 First 5 Humboldt Participant Survey, 75.2% of parent/caregiver respondents with children ages 0-2 and 64.4% of those with children ages 3-5 reported that their child is in excellent health. Data collected by the Nurse Family Partnership (NFP) Program shows that from July 2009 through December 2015 the mean percentage of immunizations completed for children from birth to two years was between 86.6-90.5% at 6, 12, 18 or 24 months.

First 5 Humboldt Participant Survey results related to parents reporting children being in excellent/good health

In 2015, 75.2% of parents surveyed with children ages 0-2 reported that their child was in excellent health. 64.4% of parents with children ages 3-5 reported the same. The 2011 California Health Interview Survey (2011 is the most recent year with statistically stable data) found that 62.4% of parents with children ages 0-5 in Humboldt County reported that their child is in excellent health. For California, this figure was 58.2%

Nurse Family Partnership immunization data

NFP tracks and submits immunization data for children in their program at 6, 12, 18 and 24 months. Figure 10 shows cumulative NFP immunization data from July 1, 2009 through December 31, 2015. The immunization rates for 18 and 24 months met the National NFP objective.

 

Oral Health indicator

  • #/% of children ages 2-5 who have used the oral health care system in the past 12 months (including prevention, screening, and treatment services)

Synopsis of results related to oral health indicator: The TOOTH (Teaching Oral Optimism throughout Humboldt) Program provided preventive services to 849 children age 0-5. According to the 2015 Participant Survey, 57.4% of parents reported that their 0-5 age child had been to the dentist in the past year.

TOOTH Program results related to oral health

The 2014-2015 Evaluation Findings and Recommendations report showed that TOOTH Program Staff served 849 preschool students in its thirteenth year of operation. Of these 849 preschool students, 573 completed at least one assessment.

The Student’s Knowledge Assessment average score increased from 55.43 to 79.38. This increase was statistically significant t(454) = -18.46, p < .0001. These results are consistent with those from all the prior program years.

In the 2014-2015 program year, plaque measurements were recorded for 357 students before and after the oral health program activities. Results showed a decrease in the average plaque index from 1.59 to 1.34. This decrease in average plaque index was statistically significant t(356) = 10.62, p < .0001. The decrease in the average plaque index has been consistent throughout all the program years (Figure 11).

 

Preschool-age participant results after participating in the TOOTH program were statistically significant.


 

First 5 Humboldt Participant Survey results related to oral health

Parents who completed the survey had a total number of 275 children ages 2-5. 76.7% of these children ages 2-5 had been to the dentist in the last year. According to the 2014 California Health Interview Survey, 82.9% of the children surveyed in California had been to the dentist in the last year. California Health Interview Survey data on this variable for Humboldt County is statistically unstable and cannot be used for comparison in this report.

 

Action: Good nutrition

Breastfeeding Indicator Breastfeeding rates at hospital discharge

Synopsis of results related to breastfeeding indicator: Paso a Paso participants breastfeed their infants at birth, at six months, and at 12 months at a rate that well exceeds the national targets for Latino/Hispanic women. Breastfeeding rates among women participating in the Humboldt County Nurse Family Partnership Program are above the Healthy People 2020 Target for initiating breastfeeding and breastfeeding at 12 months.

Paso a Paso Program results related to breastfeeding

Paso a Paso provides breastfeeding support groups for their clients. Data submitted for the period January 2015-June 2015 showed that 100% of program participants (n=39) breastfed in the early postpartum period, at three months 87% of the women were breastfeeding, at 9 months 56%, and at 12 months 54% were breastfeeding. Nationally, the targets for Hispanic women are: above 66% breastfeeding in the early postpartum period, above 29% at six months, and above 26% at one year, showing that Paso a Paso has far exceeded the national average as it has every year it has been funded.

 

Nurse Family Partnership results related to breastfeeding

Humboldt County’s Nurse Family Partnership (NFP) works with new mothers to improve child health and development. Providing support with breastfeeding is part of the program. Based on the most recent report submitted by Humboldt County’s NFP containing data from July 2009 through December 2015, 92.7% of the clients initiated breastfeeding at birth, 42.6% breastfed until 6 months, 35.8% breastfed until 12 months, 33.3% were breastfed until 18 months and 17.8% were breastfed until 24 months. The Healthy People 2020 Target goals for breastfeeding are 81.9% initiated breastfeeding at birth, 60.6% were still breastfeeding at 6 months and 34.1% were breastfeeding at 12 months. Humboldt County’s NFP was above the target goal in the area of initiating breastfeeding at birth and breastfeeding at 12 months.

 

Access to food indicators

  • Children/families have access to adequate nutrition
  • #/% eligible children/families enrolled in WIC and/or Cal Fresh

Synopsis of results related to access to food indicators: First 5 Humboldt Participant Survey results for 2015 show that 9.0% of parents/caregivers surveyed reported that in the last 12 months they or someone in their family went hungry because they could not afford to buy food. This year’s Participant Survey data also showed that 39.1% of respondents said they take part in WIC and 16.5% said they take part in SNAP (Supplemental Nutrition Assistance Program). Nurse Family Partnership (NFP) Program cumulative data shows that 63.8% of clients were enrolled in WIC and 34.5% used Food Stamps/Cal-Fresh at Intake. The rates of using these public programs increased by the time the enrolled child turned 2 years of age. In 2015, the Healthy Kids Humboldt Program (HKH) helped 434 families with children age 0-5 enroll in public programs including WIC and CalFresh.

First 5 Humboldt Participant Survey results related to access to adequate nutrition

In 2015, the percent of parents/caregivers reporting that in the last 12 months they or someone in their family went hungry because they couldn’t afford enough food decreased for the third year in a row, down from 11.7% in 2014 to 9.0% in 2015 .

 

Nurse Family Partnership results related to access to food and to enrollment in WIC, Food Stamps/Cal-Fresh

Humboldt County’s Nurse Family Partnership (NFP) nurse home visitors collect data regarding use of public programs during their visits with families. Based on the most recent report submitted by Humboldt County’s NFP, 63.8% of the families in the program between July 2009 and December 2015 were enrolled in WIC and 34.5% percent of the families had used Food Stamps/Cal-Fresh at intake. By the time the enrolled child turned 2 years of age, 80.7% of the families were enrolled in WIC and 58.1% had used Food Stamps/Cal-Fresh.

Healthy Kids Humboldt Program (HKH) results related to enrollment in WIC/CalFresh

From January-December 2015, HKH staff assisted 434 families with children age 0-5 in obtaining public program assistance including WIC and/or CalFresh, up from 426 families in 2014, 325 families in 2013, and 411 families in 2012.

 

First 5 Humboldt 2015 Participant Survey Results related to WIC/SNAP enrollment

39.1% of 2015 Participant Survey respondents said they take part in WIC. 16.5% said they take part in SNAP (Supplemental Nutrition Assistance Program).

 

 

Action: Early assessment of children’s developmental levels

Developmental indicators

  • #/% children screened (formally or informally) for appropriate developmental level
  • #/% of parents of children needing assistance in reaching developmental potentials reporting that they have social support

Synopsis of results related to developmental indicators: The Nurse Family Partnership Program conducted developmental screenings for children of clients between July 2009 and December 2015. According to 2015 First 5 Humboldt Playgroup Survey results, 5.6% of parents/caregiver survey respondents stated that the child with whom they attend playgroup has special needs, and all stated that the playgroup is a place they feel supported.

Nurse Family Partnership results related to screening for appropriate developmental level

Humboldt County’s Nurse Family Partnership (NFP) Program provided developmental screenings for children of clients between July 2009 and December 2015. Table 2a and 2b show the number of children assessed for each type of assessment at different ages.

Ages and Stages (ASQ) Assessment in NFP

Age of Child 6 months 12 months 14 months 20 months
Number of Children Assesed 113 (81%) 69 (66%) 42 (64%) 29 (60%)

Table 2a

Ages and Stages – Social and Emotional (ASQ-SE) in NFP

Age of Child 6 months 12 months 14 months 20 months
Number of Children Assesed 104 (75%) 73 (70%) 45 (68%) 32 (67%)

Table 2b

First 5 Humboldt Playgroup Survey results related to social support for parents of children needing assistance in reaching developmental potentials

5.6% of parents/caregivers responding to the Playgroup Survey in 2015 stated the child with whom they attend playgroup has special needs. In 2014, this figure was 6.4%. In 2013, this figure was 6%, in 2012 and 2011 this figure was 5% and in 2010 it was 6%. These parents/caregivers report feeling that the playgroup has provided them with a place where they feel supported as seen in Figure 18. There was a decline in scores in 2015 and after looking at possible factors that may have contributed to this drop, it was discovered that the administration of the survey coincided with a change in staff at the majority of playgroups. First 5 Humboldt will continue to monitor these scores.

The playgroup is a place… (Mean Scores for parents of a child with special needs)

Scoring: 1= strongly disagree, 2= disagree, 3= neither agree nor disagree, 4=agree, 5= strongly agree)