Texas should care more about its children

Posted Wednesday, Jul. 03, 2013  comments  Print Reprints

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The 2013 regular session of the Texas Legislature resulted in very little legislation focused on improving the health and well-being of children in Texas.

As a pediatrician and father of two, I urge Gov. Rick Perry and our lawmakers to make children a greater priority in what us now their second special session. Substantial evidence documents that this is one of the worst times to be a child in Texas:

• Texas has the second highest proportion of uninsured children of any state in our nation, at 17 percent, and the highest number of uninsured children of any state, at 1,073,000.

Indeed, since 1998, in every year but three, Texas has had the highest proportion of uninsured children of any state.

• Texas continues to have one of the most restrictive Medicaid renewal processes in the country, requiring renewal of Medicaid every six months, whereas it is only once yearly in 23 states.

• A child is abused or neglected every eight minutes in Texas, and more than 63,000 Texas children were victims of child maltreatment in 2011, third in our nation, behind only California and New York.

• A child dies in Texas before his or her first birthday every four hours. Texas is 32nd in the country in childhood death rates, at 19 per 100,000 (the U.S. rate is 18 per 100,000).

• Twenty-seven percent of Texas children (more than 1.8 million) live in poverty, a rate well above the national average, which ties Texas with Arizona for the state with the fifth-worst childhood poverty rate.

Childhood poverty is associated with a wide variety of adverse childhood outcomes, including a much higher risk of unintentional injuries, chronic illnesses, emergency-department visits, hospitalizations, admissions to the pediatric intensive care unit, and death overall and from specific conditions.

Texas has:

• The highest proportion of any state in the U.S. of third-graders with untreated tooth decay, at 43 percent.

• The second-highest proportion of households with food insecurity, at 19 percent, well above the U.S. average, and 2.1 million Texan children receive food stamps.

• The second-lowest per capita mental-health-services expenditure of any state, at $38.99, substantially lower than the national per capita expenditure of $120.56.

The most significant health-profession shortage in Texas is for mental-health services. The most recent data indicate that 173 of the 254 Texas counties are federally designated as Health Professional Shortage Areas for mental health.

A recent Hogg Foundation report noted that parental relinquishment of a child to the state protective services system in order to obtain intensive mental health services continues to be a problem in Texas.

When children with extreme emotional disturbance are at risk of hurting themselves, their families or others, intensive comprehensive services are needed but often are not accessible.

In these circumstances, parents may not have any other option for obtaining mental health services for their child except to relinquish custody to the state.

This is a horrific experience for the child and the family, and it is a costly policy for Texas.

These are often not parents who have abused their child, but parents who will do almost anything to get their child the help he or she needs.

In addition to the trauma of relinquishment, the state will label these parents as “refusing to accept parental responsibility,” and place their names on the abuse/neglect registry.

This designation can have significant ramifications for current and future employment opportunities for the parents, as they will not be able to work with or around children.

Our state’s children are experiencing a crisis.

By focusing attention on children during the special session, state lawmakers can ensure the health and well-being of the future generation of Texans.

Glenn Flores is the director of general pediatrics at Children’s Medical Center Dallas and is a resident of Tarrant County. glflores@verizon.net

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