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According to the Census 2000 data, 24.3 % of adults in Texas do not have a high school diploma.That is more than the percentage of adults with a college degree (15.6%) or graduate or professionaldegree (7.6). These averages reflect great variation in educational attainment by racial/ethnic status asshown in the table below.Educational attainment in Texas by racial/ethnic groupsHigh school diplomaLess than high schoolbut no college degreeCollege degree orhigherNon-HispanicWhites12.8 57.2 30.0Hispanics 50.7 40.4 8.9African Americans 24.2 60.5 15.3Asians 19.3 32.9 47.8Source: 2000 Census obtained from Texas State Data CenterImprovement in the educational attainment of Texans would result in better health status, lowermorbidity and mortality, and lower health care costs in Texas.PART THREE: Inventory of RecommendationsThe first section inventories general recommendations and their claims about how these interventions willaffect academic performance.E-39
Section 1. General RecommendationsTABLE 7. INVENTORY OF RECOMMENDATIONS ON GENERAL INTERVENTIONS FOR CHRONIC HEALTHCONDITIONSPolicy Reports Recommendations (Total studies = 75)Academic Performance-relatedClaimsCommunity-based● Advocate and support policies that promote “asthma friendly" communities andhomes and expand asthma control activities and interventions in high-riskpopulations particularly in low-income and minority populations. Establish diabetesprevention programs in high-risk communities that focus on the link between obesityand diabetes.● After school programs for elementary and teenage children run by local parks andrecreation departments, other public agencies, and privately-funded organizations.Head Start and childcare programs for the very young should be funded to ensurethat quality, evidenced- based physical activity is provided daily.● Establish zoning regulations that prohibit the sale of unhealthy food near schoolsas well as restrict placement and operating hours of restaurants near schools.Require hospitals and other health care facilities to sell only healthful foods.● Design or provide incentives to developers that build communities that promotehealthy eating and physical activity. Encourage location of grocery stores instead ofliquor stores in low-income neighborhoods, and increase healthy and competitivelypriced food choices. Promote communities where it’s easy and safe to walk and bike.Requirements for new schools to be sited and planned should include objectives toensure that students who live within one mile can safely walk or ride to school.School renovation funds and transportation funds should be allocated forimprovements to schools and transportation infrastructure that facilitate studentswalking to school. Building more trails and paths to encourage walking, jogging andcycling.● Commit all schools to participate inavailable child nutrition programs,including breakfast, lunch, afterschool snacks, child care andsummer food service.● Ensure there is staff and space forquality physical education.● Hire credentialed physicaleducation teachers for elementaryschools.● Institute a state subject matterproject for physical education andhealth and provide funding forschools to adopt evidence-basedphysical education programs andprovide incentive funding to teachersto prepare for the nationalprofessional board exam insecondary physical education andelementary physical education.● Educate families on disease risk factors, prevention and management. Encourageparents and caregivers to promote healthy eating patterns by offering nutritioussnacks, such as vegetables and fruits, low-fat dairy foods, and whole grains;encouraging children’s autonomy in self-regulation of food intake and settingappropriate limits on choices; and modeling healthy food choices.● Encourage community health workers to participate in diabetes prevention andtreatment programs.● Establish a pilot program to demonstrate the effectiveness of comprehensivecommunity-based initiatives focusing on obesity and type 2 diabetes in children andadolescents. Information about successful community projects for people withasthma should be made available to local officials.● The Legislature should requireschools to provide breakfast.● School districts should elect toinclude formal curriculum on physicalactivity and physical educationinstruction in kindergarten throughtwelfth grades. Teachers should begiven education and training on howto model physical activity behaviors.Health care access/delivery/coverage● Improve access to quality care and services utilization and culturally appropriateservices.● Increase the proportion of people with asthma who receive written asthmamanagement plans from their health care provider. Provide case-management tohigh-risk children.● Pediatricians should develop simple appraisal methods to enable schools/familiesand their health centers to identify when children are becoming obese.● Improve health coverage for uninsured or underinsured children withasthma/diabetes and expand insurance to preventive services. Ensure broaderaccess to asthma/diabetes medications and supplies. Expand the insurance benefitsto cover for preventive services and reimburse preventive community healthprofessionals.● Good public policy on asthma canincrease school attendance andeducational attainment. Asthmarelatedabsenteeism negativelyaffects children’s learning potential.● Poor asthma control often results intime away from school, work, sports,or other activities that affect thequality of life. Even if the individualwith asthma is able to attend work orschool, ongoing symptoms orE-40
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Appendix ATask Force Members and St
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Hector Balcazar, Ph.D.Regional Dean
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Charles Haley, M.D., M.S.Medical Di
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Michael McKinney, M.D.Senior Execut
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M. Roy Wilson, M.D.PresidentTexas T
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Appendix BMedicaid and the State Ch
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services. There are two broad types
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Mandatory and Optional Covered Popu
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• Nurse-midwife services;• Fede
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Disproportionate Share Hospital Pro
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March 13, 2001, that limited the am
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year from FFY 2002-2004, $4.05 bill
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Medicaid beneficiaries. Section 191
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started in 2001 and 2002 to curb in
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urban and with fewer than 250,000 p
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Protection Act of 2000 and the Medi
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orientation). Recipients of Supplem
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enrollee is assigned a primary care
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Table 7. Texas Medicaid Policy Chan
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Table 8. Texas SCHIP Policy Changes
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families (through the employer’s
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share of the match must come from t
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Reinstating the Medically Needy Spe
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Endnotes1 Texas Health and Human Se
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35 Powers, Pyles, Sutter, and Vervi
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73 Office of Management and Budget,
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113 TexCare, Children’s Health In
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150 Lyndon B. Johnson School of Pub
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States by Groupings with Current El
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Medicaid and the State Children’s
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Graduate Medical Education ProgramA
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needs, however, there is a shortage
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15 Texas Association of Counties,
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ecording and evaluation; physical e
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Medicaid and the State Children’s
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ReferencesAmerican Academy of Pedia
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downloads/bipa.pdf#search='Medicare
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Texas Health and Human Services Com
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Appendix CAn Analysis of Reform Opt
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Encouraged by these low rates, Cong
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Establishing state-only tax incenti
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New York passed the Health Care Ref
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Hospital Cost Containment — Maryl
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dollar spent. 237 Texas spent almos
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Another option for small businesses
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• Medical equipment and supplies,
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pay the premiums for Medicaid benef
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Medicaid to children born after Sep
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Bill of Rights or “TABOR”; and
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The federal share for CHP+ is 65 pe
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SCHIP: increased eligibility in CHP
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• Medical equipment and supplies
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6. Funds obtained through the recov
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Status ReportMaineCare Program Expa
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the federal poverty level. 404 Sinc
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need their jobs as a source of empl
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Endnotes191 Deborah Chollet, Issue
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225 Ibid.226 Maryland Health Care C
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259 Kaiser Family Foundation, State
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SCHIP&subcategory=Medicaid+Spending
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325 Kaiser Family Foundation, State
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361 State Coverage Initiatives, Sta
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SCHIP&subcategory=SCHIP&topic=Feder
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An Analysis of Reform Options Devel
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ReferencesAdvantage Insurance and F
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Donnell-Kay Foundation. “Amendmen
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Kaiser Family Foundation. Demograph
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State Coverage Initiatives. Profile
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Appendix DLocal Initiatives to Expa
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with more coordinated services that
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FinancingSources of revenue include
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AdministrationThe Health and Hospit
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Until 1993, Denver Health (DH) was
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different benefit plans are offered
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Cost SharingPatient cost-sharing is
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management programs. I-Care promote
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the county indigent care plan. Bene
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Firstplan xxvi,12Moore County, Mich
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Benefits and ServicesEnrollees can
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EligibilityAs of 2005, enrollment i
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etween $23 and $120 per month. Ther
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Healthcare Accountability Act xxxvi
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Coordination - When health care age
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subsidized initiatives offer exposu
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arriers, two health plans attempted
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Page 176 and 177: Table 1 (Continued). Local Care Ini
Page 178 and 179: Table 2 (Continued). Local Coverage
Page 180 and 181: Appendix EEducation and Health:A Re
Page 182 and 183: The human capital approach suggests
Page 184 and 185: etween standardized test scores (St
Page 186 and 187: INTRODUCTIONEducation plays a wide
Page 188 and 189: of children with chronic health con
Page 190 and 191: Implications. Given the current pre
Page 192 and 193: DiabetesPrevalence. Diabetes in chi
Page 194 and 195: Limitations. The cross-sectional de
Page 196 and 197: chronic lung disease, cystic fibros
Page 198 and 199: significant differences between tho
Page 200 and 201: Table 1. Prevalence of Selected Chr
Page 202 and 203: findings of lower test scores are b
Page 204 and 205: al (McKewen et al., 1998) report a
Page 206 and 207: Section 3. School-Based Interventio
Page 208 and 209: mathematics, science and oral expre
Page 210 and 211: Table 4. Summary of Research Findin
Page 212 and 213: etween SES and health is a dose-res
Page 214 and 215: Self-Rated Health. Evidence accumul
Page 216 and 217: economic hardship. One of the skill
Page 218 and 219: Education also improves the stabili
Page 220 and 221: sex in the expectation of a more pr
Page 222 and 223: TABLE 6. SUMMARY OF EXPLANATIONS FO
Page 226 and 227: Policy Reports Recommendations (Tot
Page 228 and 229: Section 2. Recommendations on Schoo
Page 230 and 231: Childhood ConditionsSchool-based Pr
Page 232 and 233: Childhood ConditionsDiabetes (n=11)
Page 234 and 235: eduction in reading test scores com
Page 236 and 237: Table 10. Estimates of the Cost of
Page 238 and 239: National Asthma Education and Preve
Page 240 and 241: REFERENCESAck, M., Miller, I., & We
Page 242 and 243: Elo, I. T., & Preston, S. H. (1996)
Page 244 and 245: Kaemingk, K. L., Pasvogel, A. E., G
Page 246 and 247: Miller, D. S., & Miller, T. Q. (199
Page 248 and 249: Ross, C. E., & Wu, C. L. (1996). Ed
Page 250 and 251: Williams, D. R. (1990). Socioeconom
Page 252 and 253: SAMPLE, DESIGN, & INTERVENTIONACHIE
Page 254 and 255: SAMPLE, DESIGN, & INTERVENTIONStudy
Page 268 and 269: SICKLE CELL ANEMIAArmstrong(1996)SA
Page 272 and 273: SAMPLE, DESIGN, & INTERVENTIONSickl
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SAMPLE, DESIGN, & INTERVENTIONhemog
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SAMPLE, DESIGN, & INTERVENTIONACHIE
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SAMPLE, DESIGN, & INTERVENTIONStudy
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Curriculum Content: Statute §28.00
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• HEALTH PROMOTING ENVIRONMENTSch
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• COORDINATION/IMPLEMENTATIONCoor
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Education and Health: A Review and
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Appendix FState Regulation of Healt
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coverage they offer. 14 By 2004 onl
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poor health may make coverage more
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account for most, or even much, of
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More active state intervention in t
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Table 3 (GAO Appendix IV) shows whi
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Appendix GEmergency and Trauma Care
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The treatment of shock prior to sur
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the EMS needs in rural areas of the
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Level IV trauma centers should be a
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Table 2. Trends in Trauma Severity,
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the hospitals were on diversion or
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Representative Delisi was successfu
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Mental Health Access ChallengesCare
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fhttp://www.techproservices.net/his
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oohttp://www.saveourers.org/reports
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Appendix HBrief: Consulate ClinicDe
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In addition, the roundtable discuss
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clinic(s) affiliated with medical s
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Appendix ICommon Abbreviations
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HMOHRQOLHRSAICF/MRIHCTAIOMISSLBBLIU
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Appendix JPresentersDate/Location:
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Appendix KProvider Taxes: A Differe
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were previously categorized as char
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