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Health 2016

Health 2016

64% of uninsured Nebraska kids are low-income.1

87.4% of Nebraska children are in very good or excellent health.2

1. U.S. Census Bureau, 2015 American Community Survey 1-year estimates, Table B17016.
2. Data Resource Center for Child & Adolescent Health, National Survey of Children’s Health, 2011/12.

Why does it matter?

All children deserve access to affordable, quality physical and behavioral health care.

Quality and consistent preventive health care, beginning even before birth, gives children the best chance to grow up to be healthy and productive adults.

Adequate levels of immunization, public health efforts to prevent disease and disability, and support for maternal health and positive birth outcomes are examples of measures that help children now and later. Good health, both physical and behavioral, is an essential element of a productive and fulfilling life.

Where are the data?

Births 

26,678 babies were born in 2015. That’s a slight decrease from 26,794 births in 2014.

Births by race & ethnicity (2015)

  • White (77.6%)
  • Other Race (9.6%)
  • Black/African American (7.2%)
  • Asian or Pacific Islander (3.6%)
  • American Indian or Alaska Native (1.7%)
  • Unknown (0.2%)
  • Not Hispanic (84%)
  • Hispanic (16%)
16% of babies received inadequate prenatal care.

Women who see a health care provider regularly during pregnancy have healthier babies and are less likely to deliver prematurely or to have other serious pregnancy-related problems. The ideal time for a woman to seek out prenatal care is during her first trimester or even prior to getting pregnant.

Barriers to care can include a lack of any of the following:
• insurance,
• transportation,
• knowledge of where to find care,
• quality treatment at care center,
• translation services, and
• knowledge of importance of care.

Trimester prenatal care began (2015)

  • First (73.2%)
  • Second (21.1%)
  • Third (4.7%)
  • None (1.0%)
Source: Vital Statistics, Department of Health and Human Services (DHHS).

 Pre/post-natal health

Folic acid use prior to pregnancy (2013)1

  • 4 or more times/week before pregnancy (40.8%)
  • 3 or fewer times/week before pregnancy (59.2%)

Mother’s BMI prior to pregnancy (2013)1

  • Underweight before pregnancy (9.6%)
  • Normal weight before pregnancy (49.3%)
  • Overweight before pregnancy (15.0%)
  • Obese before pregnancy (26.1%)

Tobacco use (2015)2

  • Did not use tobacco during most recent pregnancy (89.9%)
  • Used tobacco during most recent pregnancy (10.1%)

Pregnancy intendedness (2013)*1

  • Unintended pregnancy (27.9%)
  • Intended Pregnancy (72.1%)

Breastfeeding (2013)1

  • Ever breastfed (89.1%)
  • Never breastfed (10.9%)

Low birth weight (2015)2

  • Not low birth weight (92.9%)
  • Moderately low birth weight (6.0%)
  • Very low birth weight (1.1%)
Domestic violence1 2013
Experienced physical abuse from husband or partner in the 12 months before pregnancy 2.7%
Experienced physical abuse by someone other than husband or partner in the 12 months before pregnancy 1.5%
Child birth classes1 2013
Participated in child birth classes during most recent pregnancy 24%
Maternal depression1 2013
New mothers who experienced maternal depression related to most recent pregnancy 11%
*This data is not comparable to years 2011 and prior due to changes in methodology.
1. PRAMS, 2013.
2. Vital Statistics, Department of Health and Human Services (DHHS).

Teen births & sexual behavior 

Teen parenting

While teen pregnancy occurs at all socio-economic levels, teen moms are more likely to come from economically-disadvantaged families or to be coping with substance abuse and behavioral problems. Teen birth is highly correlated with child poverty.

In turn, children born to teenage parents are more likely to live in poverty, experience health problems, suffer from maltreatment, struggle in school, run away from home, and serve time in prison. Children of teen parents are also more likely to become teen parents themselves, thus perpetuating the cycle of teen pregnancy and generational poverty.

Teen births are at the lowest point in a decade. In 2015 there were 1,397 babies born to teen mothers, 379 to mother’s who were 10-17 years old, 1,018 to mother’s who were 18 or 19.2

Teen births (2006-2015)

  • Ages 10-17
  • Ages 18-19
Source: Vital Statistics, Department of Health and Human Services (DHHS).

Teen births by age (2015)

  • Ages 18-19 (72.9%)
  • Ages 16-17 (23.4%)
  • Ages 14-15 (3.5%)
  • Ages 10-13 (0.2%)
Source: Vital Statistics, Department of Health and Human Services (DHHS).
Teen sexual behavior1
2015
Ever had sexual intercourse 32.5%
Reported having sexual intercourse before age 13 3.3%
Had sex with four or more people 8.0%
Had sex in the past 3 months 24.9%
Drank alcohol or used drugs before last sexual intercourse 17.9%
Did not use a condom during last sexual intercourse 43.0%
Did not use any method to prevent pregnancy during last sexual intercourse 17.8%

HIV/AIDS3

In 2015, there were 8 children ages 0-11 and 12 children ages 12-19 living with HIV.

Since 2005, only 3 children with a diagnosis of HIV or AIDS have died from the disease.

1. Center for Disease Control and Prevention, Youth Risk Behavior Survey, 2015.
2. Vital Statistics, Department of Health and Human Services (DHHS).
3. HIV Surveillance, Nebraska Department of Health and Human Services (DHHS).

Sexually transmitted infections (STIs) (2006-2015)2

There were 2,303 cases of sexually transmitted infections reported in children ages 19 and under in Nebraska in 2015.

 Infant & child deaths

Infant mortality*

Infant mortality decreased to 5.1 per 1,000 births in 2014 from 5.3 per 1,000 births in 2013.

Causes of infant deaths (2014) Number Percent
Birth Defects 41 30.1%
Maternal and Perinatal 34 25.0%
SIDS/SUDI 21 15.4%
Prematurity 16 11.8%
Respiratory and Heart 11 8.1%
Accidents 3 2.2%
Infection 1 0.7%
Other 9 6.6%
Total 136

Child deaths*

In 2014, 125 children and youth ages 1 to 19 died of various causes, the most common of which were accidents and suicide.

Causes of child deaths (2014) Number Percent
Accidents 43 34.4%
Suicide 19 15.2%
Birth Defects 13 10.4%
Homicide 10 8.0%
Cancer 7 5.6%
Other 33 26.4%
Total 125

Rate of infant mortality per 1,000 births by race and ethnicity (2014)

Child deaths, ages 1-19 (2005-2014)

*2015 mortality data was unavailable at the time of publication of this report. When data is made available it will be updated electronically in this report and in the Nebraska Kids Count NEteractive Data Center found at voicesforchildren.com.
Source: Vital Statistics, Department of Health and Human Services (DHHS).

Health Insurance 

Health coverage for Nebraska’s children, ages 17 & under (2015)1

  • Public Insurance
  • Employer-Based Insurance
  • Direct-Purchase Insurance
  • Uninsured

Access to health care

In 2015, there were 24,078 (5.2%) uninsured children in Nebraska. Of those, 15,506 (64%) were low-income (below 200% of the federal poverty level) and likely eligible, yet unenrolled, in the Children’s Health Insurance Program (CHIP).1

Percent uninsured children by race/ethnicity (2010-2014)2
Black/African American 4.1%
Asian or Pacific Islander 6.0%
Other, or 2+ races 9.4%
White, non-Hispanic 4.2%
Hispanic 11.6%
American Indian and Alaska Native 16.3%

5.2% of kids did not have health insurance in 2015.1

Medicaid and CHIP served a monthly average of 162,087 children in SFY 2015.3

69% of those eligible for Medicaid are children, but children only make up 27% of Medicaid costs.3

Nebraska Medicaid average monthly eligible persons by age (SFY 2015)3

  • Blind/Disabled (14.8%)
  • Aged (8.3%)
  • Adults (2.6%)
  • Children (74.3%)

Nebraska Medicaid expenditures by age (SFY 2015)3

  • Blind/Disabled (45.5%) $853,590,754
  • Aged (20.8%) $389,624,456
  • Adults (7.3%) $137,159,142
  • Children (26.5%) $496,914,266

CHIP/Medicaid enrollment (SFY 2015)3

  • Medicaid (77.3%)
  • CHIP (22.7%)
1. U.S. Census Bureau, 2015 American Community Survey 1-year estimates, Table B27016.
2. U.S. Census Bureau, 2014 American Community Survey 5-year estimates, Tables C27001B-I.
3. Financial and Program Analysis Unit, Nebraska Department of Health and Human Services (DHHS).
Notes: “Children” category combines Medicaid and CHIP coverage. “Adults” are those aged 19-64 receiving Aid to Dependent Children, or temporary cash assistance through the state of Nebraska.

 Behavioral Health

Estimating mental health needs

Many children in Nebraska deal with behavioral health problems that may affect their ability to participate in normal childhood activities.

An estimated 37,539 Nebraska children face behavioral health disorders.

  • Anxiety: 9,263
  • ADD/ADHD: 15,870
  • Behavioral or conduct problems: 7,770
  • Depression: 4,636
Source: Data Resource Center for Child and Adolescent Health, childhealthdata.org.
Considered suicide in last 12 months (2015)3
Seriously considered suicide 14.6%
Had suicide plan 13.3%
Made suicide attempt 8.9%

Children receiving community-based mental health services (2015)4

  • Mental Health
  • Serious Emotional Disturbance
  • Mental Health and Substance Abuse
  • Substance Abuse
1. Financial and Program Analysis Unit, Department of Health and Human Services (DHHS).
2. National Survey of Children’s Health, 2011/12.
3. Centers for Disease Control and Prevention, Youth Risk Behavior Survey.
4. Division of Behavioral Health, Department of Health and Human Services (DHHS).

20,604 Nebraska children received mental health and substance abuse services through Medicaid or CHIP in 2015.1

20.6% of children four months to five years were at moderate to high risk of behavioral or developmental problems based on parents’ specific concerns.2

70.7% of children needing mental health counseling actually received it.2

24.1% of teens felt sad or hopeless (everyday for 2+ weeks so that activity was stopped in last 12 months).3

Regional centers (2015)4

84 males

received services at Hastings Regional Center, a chemical dependency program for youth from the Youth Rehabilitation & Treatment Center (YRTC) in Kearney.

23 males

received services from Lincoln Regional Center at the Whitehall Campus.

Health Risks 

Motor vehicle behavior among high schoolers 2015
Rarely or never wore a seat belt 11.3%
In past 30 days, rode in a vehicle driven by someone who had been drinking alcohol 22.3%
In past 30 days, drove a motor vehicle after drinking alcohol 10.1%
In past 30 days, texted or emailed while driving a car or other vehicle 49.4%
Injuries and violence among high schoolers 2015
In past 12 months, was physically hurt on purpose by someone they were dating 8.1%
In the past 12 months, was threatened or injured with a weapon on school property 7.1%
In past 12 months, was bullied on school property 26.3%
Has ever been physically forced to have sexual intercourse 8.3%
In past 12 months, was in a physical fight 2.8%
In past 12 months, was electronically bullied 18.9%
Source: Centers for Disease Control and Prevention, Youth Risk Behavior Survey, 2015.
Alcohol and other drugs among high schoolers 2015
Ever used marijuana 26.6%
Ever used any form of cocaine 5.3%
Ever used meth 4.2%
Ever used ecstasy or MDMA 5.1%
In past 12 months, offered, sold, or given an illegal drug by someone on school property 19.9%
Ever tried smoking 31.4%
Currently uses smokeless tobacco 9.3%
In past 30 days, had at least 1 drink of alcohol 22.7%
In past 30 days, had 5 or more drinks in a row within a couple of hours 14.3%
Ever took prescription drugs without a doctor’s prescription 13.5%
Currently smokes 13.3%

Motor vehicle accidents (2015)

15 children died and 135 children suffered disabling injuries in motor vehicle accidents.

Source: Nebraska Department of Roads.

Blood Lead Level Testing (2015)

Exposure to lead may harm a child’s brain and central nervous system. Even low blood lead concentrations can cause irreversible damage such as:

  • impaired physical and cognitive development,
  • delayed development,
  • behavioral problems,
  • hearing loss, and
  • malnutrition.

The Statewide Blood Lead Testing Plan has detailed guidance on recommendations for when children should have their blood tested for lead. The Centers for Disease Control uses a reference level of 5 micrograms per deciliter to identify children as having an elevated blood lead level.

In 2015:

31,666 children were tested.

344 had elevated blood
lead levels,
representing 1.1% of
all children tested,
the same as 1.1% in 2014.

Source: Nebraska Department of Health and Human Services (DHHS).

Obesity, dieting, activity, and eating habits

In past 7 days did not eat fruit or drink 100% fruit juice 5.6%
In past 7 days did not eat vegetables 6.4%
Were currently overweight or obese according to CDC growth charts 29.9%
In past 7 days did not participate in at least 60 minutes of physical activity on any day 14.1%
Source: Centers for Disease Control and Prevention, Youth Risk Behavior Survey, 2015.

Adverse Childhood Experiences

Adverse childhood experiences (ACEs) are potentially traumatic events that can have negative, lasting effects on health and well-being.

Number of ACEs (2011/12)

  • 0 ACEs (56%)
  • 1-2 ACEs (32%)
  • 3+ ACEs (11%)
Source: Child Trends, Adverse Childhood Experiences, National and State Level Prevalence, 2014.

Most Common ACEs (2011/12)

Domestic violence & sexual assault*

Nebraska’s Network of Domestic Violence/Sexual Assault Programs includes 20 community-based programs. There are also four tribal programs which comprise the Nebraska Tribal Coalition Ending Family Violence. The tribal domestic violence/sexual assault programs are with the Winnebago Tribe of Nebraska, the Santee Sioux Nation, the Ponca Tribe of Nebraska, and the Omaha Tribe.

Service participants (2015)*

*Data does not include information from the Nebraska Tribal Coalition Ending Family Violence.
Source: Nebraska Coalition to End Sexual and Domestic Violence.

Services provided to children served (2015)*

 Health Services

Medical provider shortage

Medically underserved areas (MUA) or populations (MUP) are defined as those where residents may have access to too few primary care providers, have high infant mortality rates, have high poverty, and/or a high elderly population.

Health professional shortage areas are designated as having too few primary medical, dental, or mental health care providers.

83.9% of children had a preventive medical visit in the past year.2

79.9% of children had a preventive dental visit in the past year.2

Immunizations (2015)3

73.8% of Nebraska children had received the primary immunization series* by age three.
78.1% of Nebraska teens were immunized against meningitis.
48.2% of Nebraska teen girls and 32.2% of Nebraska teen boys completed the 3rd round of the HPV vaccine.

Number of counties with a medical provider shortage (2015)1

Medical home (2011/12)2

A patient-centered medical home is a primary care physician or provider that serves as a child’s usual source of care. It is an important mechanism for coordination of all segments of health – physical, behavioral, and oral.

  • 39.9% do not have a medical home
  • 61.1% have a medical home
1. Shortage Designation, Health Resources and Services Administration, U.S. Department of Health and Human Services.
2. 2011/12 National Survey of Children’s Health.
3. Immunization Program, Nebraska Department of Health and Human Services (DHHS).
*Series 4:3:1:3:3:1:4