2018 PRC Child & Adolescent Health Needs Assessment

Executive Report

2018 PRC Child & Adolescent Health Needs Assessment

Total Service Area

Broward, Collier, Lee, Miami-Dade, Monroe & Palm Beach Counties, Florida

Prepared for: Nicklaus Children's Hospital

By: Professional Research Consultants, Inc. 11326 P Street Omaha, NE 68137-2316

2018-1144-02 ? December 2018

CHILD & ADOLESCENT HEALTH NEEDS ASSESSMENT

Table of Contents

Introduction

6

Project Overview

7

Project Goals

7

Methodology

7

IRS Form 990, Schedule H Compliance

15

Summary of Findings

16

Significant Health Needs of the Community

16

Summary Tables: Comparisons With Benchmark Data

20

Summary of Key Informant Perceptions

40

Community Description

41

Age

42

Linguistic Isolation

43

Children in Low-Income Households

44

Perceptions of Top Health Issues

46

Child Health

47

Perceived Top Health Issues

47

Perceived Availability of Resources

48

Adolescent Health

49

Perceived Top Health Issues

49

Perceived Availability of Resources

50

Health Status

51

Overall Health Status

52

Evaluations of Child's Overall Health

52

Activity Limitations

54

Loss of Productivity

56

Mental Health

59

Evaluation of Child's Mental Health

59

Depression

61

Suicide Attempts (Adolescents)

64

Anxiety

65

Sleep Difficulties

68

Cognitive & Behavioral Disorders

69

Key Informant Input: Cognitive & Behavioral Conditions

74

Mental Health Services & Treatment

78

Key Informant Input: Mental and Emotional Health

86

2

CHILD & ADOLESCENT HEALTH NEEDS ASSESSMENT

Chronic Disease & Special Health Needs

Prevalence of Selected Medical Conditions Vision, Hearing & Speech Allergies Neurological Conditions Bone, Joint & Muscle Problems Asthma Diabetes Cancer Condition Requiring Prescriptions or Special Therapy Use of Prescribed Medications

Special Health Needs Prevalence of Special Health Needs Parents' Greatest Needs for Child

Prenatal & Postnatal Care

Prenatal Care Lack of Prenatal Care Difficulties Getting Prenatal Care Prenatal Healthcare Planning

Births to Teen Mothers Low-Weight Births Vaccinations

Immunization Prevalence Vaccinating Newborns Breastfeeding & Breast Milk Ever Breast-Fed Exclusive Breastfeeding for Six Months Infant Health Key Informant Input: Infant Health

Mortality

Infant Mortality Child & Adolescent Deaths

Mortality Rates Leading Causes of Child Deaths

Modifiable Health Risks

Nutrition Fruits & Vegetables Fast Food Family Meals

90

91 91 98 103 108 110 115 118 118 120 121 121 122

123

124 124 126 128 130 132 134 134 134 136 136 136 138 138

140

141 143 143 145

146

147 148 151 153

3

CHILD & ADOLESCENT HEALTH NEEDS ASSESSMENT

Physical Activity Recommended Physical Activity Vigorous Physical Activity Screen Time

Weight Status Childhood Overweight & Obesity Perceptions of Overweight

Tobacco, Alcohol & Other Drugs Exposure to Environmental Tobacco Smoke Tobacco Use (Adolescents) Alcohol (Adolescents) Drug Use (Adolescents) Awareness of Substance Abuse Resources

Injury & Safety Prevalence of Injuries Motor Vehicle Injuries Head Injuries Child Abuse Prevalence Neighborhood Safety School Safety

Sexual Activity Chlamydia & Gonorrhea Sexual Activity Among Adolescents Human Papillomavirus (HPV) Vaccine

Access to Health Services

Health Insurance Coverage Type of Health Insurance Coverage Lack of Health Insurance Coverage

Difficulties Accessing Healthcare Barriers to Healthcare Access Loss of Productivity

Access to Specialty Care Outmigration for Children's Healthcare Primary Care Services

Access to Child Healthcare Specific Source of Ongoing Care Receipt of Routine Medical Care Previous Child Health Care Visit Dental Care Vision & Hearing

155 155 157 157 163 163 166 170 170 171 174 176 179 184 184 187 189 193 193 195 202 202 202 204

209

210 210 210 214 215 217 220 223 225 225 226 228 230 231 237

4

CHILD & ADOLESCENT HEALTH NEEDS ASSESSMENT

Emergent & Urgent Care Emergency Room Utilization Urgent Care Centers/Walk-In Clinics

Health Education & Outreach

Primary Source of Healthcare Information Willingness to Use Personalized Medicine Likely Participation in Clinical Research Trials

Resources

Resources Available to Address the Significant Health Needs

Appendix

Nicklaus Children's Hospital: 2015-2018 Implementation Plan Program Evaluation

Nutrition, Physical Activity & Weight Mental Health Access to Healthcare Services Diabetes Injury & Violence Asthma & Other Respiratory Conditions Oral Health Potentially Disabling Conditions

242 242 244

246

247 249 250

253

254

258

259 259 262 264 267 268 269 270 271

5

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