CHIS 2001 is the largest health survey ever conducted in any state and one of the largest in the nation. CHIS 2001 is the first health survey to provide detailed information on the health of young children in California, both statewide and for many counties. The study examines the health, access to health care and well-being of young children, all of which affect children's ability to reach their greatest potential in school and in life. The report notes that the lack of access to health care and quality child care for many young Californians may have long-term consequences for children's development and ability to grow and learn. The survey is a collaboration of the UCLA Center for Health Policy Research, the California Department of Health Services and the Public Health Institute.
CHIS 2001, funded in part by First 5 California and other agencies, is the first to provide information about key measures of health and well-being for the state's 3 million children under age 6, focusing on patterns and disparities related to children's family, social structure and environment. Hardest hit are low-income and minority children, particularly Latino children, who represent 50 percent of California's youngest children.
"These new CHIS findings underscore the urgent need to invest in quality preschool and health care," said E. Richard Brown, director of the UCLA Center for Health Policy Research and professor in the UCLA School of Public Health. "Disparities among different populations reveal where we need to invest in services. For example, African-American children are more likely to be diagnosed with asthma, whereas Latino children are less likely to be enrolled in preschool. By focusing on these disparities, the report points the way for communities, health professionals and policy-makers to improve California children's health, developmental growth and readiness for school."
"Before UCLA released the CHIS 2001 study, there was no resource that painted such a complete picture of California's youngest children, particularly in regard to their health and well-being," said Rob Reiner, chair of First 5 California. "Without quality health care, our children can't learn, play and develop the skills they need to succeed later on in life. Relatively small investments in our children now will pay huge long-term economic dividends to our state in reduced drop-out rates, reduced crime and increased tax collection."
According to the UCLA report, there is room for improvement in conditions affecting all children. "CHIS shows that health and dental care as well as parent activities at home are falling short of what is needed for young Californians of all incomes and ethnicities," said report lead author Moira Inkelas, adjunct assistant professor in the UCLA School of Public Health and assistant director of the UCLA Center for Healthier Children, Families and Communities.
The UCLA report also provides a glimpse of how ready young children will be to enter school. "CHIS provides information on young children's well-being at an opportune time, given current state and local initiatives to help young Californians have the experiences they need to begin school ready to learn," said report co-author Neal Halfon, professor in the UCLA Schools of Public Health, Medicine, and Public Policy and Social Research, and director of the UCLA Center for Healthier Children, Families and Communities. "We know from research studies that children who enter kindergarten without the physical, cognitive and social skills they need will lag behind their peers and have a hard time catching up, and important opportunities to shape children's futures are being missed."
CHIS 2001 provides information about children under 6 years based on interviews with more than 55,000 randomly selected households from every county in California. The report focuses on several First 5 California strategic priority areas, such as overall health status, access to quality health and child care services, special needs and disabilities, oral health, asthma, nutrition, and important early experiences for young children, including reading and attending preschool.
The report provides the first statewide data on California's potential to close the gap for children who are eligible for health insurance but not enrolled. Approximately 202,000 children under the age of 6 are uninsured. According to CHIS 2001, about 80 percent of those children are uninsured despite being eligible for Healthy Families or Medi-Cal. In particular, Latino children and those in low-income families are four times less likely to have health insurance. The report states that targeted outreach, enrollment and retention efforts are needed to extend health insurance to more children and develop policies and programs to fill existing gaps.
The study also found that many preschool-age children spend no time in structured preschool settings. There are large disparities in preschool attendance among California's ethnic populations. CHIS 2001 shows that, overall, approximately 22.4 percent of children ages 3–5 years are in a preschool program such as Head Start, preschool or nursery school. Of children ages 3–5 years, only 12.5 percent of Latino children are enrolled compared to 36 percent African-American, 32.1 percent American Indian/Alaska Native, 28.9 percent non-Hispanic white and 23.4 percent of Asian/Pacific Islander children.
In order to provide a representative sample of California's diverse communities, the CHIS 2001 questionnaires were translated and interviews were conducted in six languages: English, Spanish, Chinese (Mandarin and Cantonese), Vietnamese, Korean and Khmer (Cambodian). In addition, special community outreach campaigns were conducted to encourage participation by underrepresented groups.
To monitor the status of California's children, CHIS will continue to measure key indicators every two years. CHIS will also have the opportunity to interview the same participants over time to obtain more in-depth information about particular topics, such as access to health and child care as well as early-childhood services.
Programs funded by local First 5 Commissions are designed to help bridge the gap in quality and availability of services for children under age 6. Acting on research findings that a child's brain develops most dramatically during the first five years, First 5 California has spearheaded efforts to improve the quality and availability of health and early-childhood development programs for children ages 0 to 5. To date, nine County Commissions have allocated approximately $152 million towards universal health care. The Healthy Kids Initiative provides health insurance to children who are ineligible for other publicly funded health insurance programs. In addition, several County Commissions have spearheaded efforts to make preschool available to all children, such as First 5 LA, which has invested $100 million toward universal access to preschool, targeting 3- to 5-year-old children in Los Angeles County.
First 5 California, also known as the California Children and Families Commission, was established after voters passed Proposition 10 in November 1998, adding a 50 cents-per-pack tax on cigarettes to fund education, health, child care and other programs for expectant parents and children from birth to age 5. Prop. 10 was designed to address the lack of public funding and support for early-childhood development in the wake of a growing body of scientific evidence indicating that the emotional, physical, social and developmental environments to which children are exposed have a profound impact on their ability to reach their greatest potential in school and in life. Prop. 10 generates approximately $600 million in tobacco taxes annually. Eighty percent of this funding is distributed among the state's 58 County Commissions and 20 percent is allocated to the State Commission.
The UCLA Center for Health Policy Research, established in 1994, is one of the nation's leading health policy research centers and the premier source of key health policy information for California. It is based in the UCLA School of Public Health and is also affiliated with the UCLA School of Public Policy and Social Research. The UCLA Center for Healthier Children, Families and Communities is an interdisciplinary research center on health policy for children and families, housed in the UCLA schools of Public Health and Medicine.
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