Opportunities to Promote Children's Behavioral Health Health Care Reform and Beyond: Workshop Summary (2015) / Chapter Skim
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2 Responding to the Challenge
2 Responding to the Challenge
Pages 7-22
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From page 7... ...
, observed Neal Halfon, director of the University of California, Los Angeles (UCLA) , Center for Healthier Children, Families, and Communities and professor at UCLA's David Geffen School of Medicine, the Fielding School of Public Health, and the School of Public Affairs, in his keynote address at the workshop.
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From page 8... ...
Today it is a boy with autism. "This steadily increasing trend in childhood disability is staring us right in the face, yet we are not doing much to change it." According to definitions established by the Maternal and Child Health Bureau, 4 to 6 percent of children have severe disabilities and 14 to 18 percent have special health care needs (Brault, 2012)
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. A developmental mismatch has emerged that is characterized by accelerated biological development, accelerated and unstable social development, unprotected and unsupported development for many adolescents, segregated development separate from parents and families, and technologyand market-dominated development, according to Halfon.
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From page 10... ...
At the same time, the child health system is characterized by fragmented service delivery, difficulty accessing services, large inequities, low and uneven quality, models of care that are outmoded and do not match current needs, limited local responsibility, and enormous resource constraints, said Halfon. The overall result is a gap between current practice and the ideal child development trajectory.
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From page 11... ...
Health care historically has focused from the "neck down" rather than on what Halfon dubbed the "entals" -- mental, developmental, and dental health. Strategies focused on only the marginal risk, which Halfon dubbed the "fix it" mentality, can be helpful, but real change will require more transformative changes.
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From page 12... ...
. Halfon referred to this new model as the life course health development synthesis (see Figure 2-3)
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From page 13... ...
SOURCE: Halfon, 2015. From Life Course Research Network (LCRN)
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From page 14... ...
For example, a redesign to achieve a higher health trajectory might combine nurse–family partnerships, Early Head Start, child care resources and referrals, home-visiting networks, and parenting support. Such a system would require connecting pediatric offices to a much broader array of services and interventions.
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. "We need to get not just 10 communities but 1,000 communities over the next 10 years to transform their children's health systems and make those kinds of innovations." New apps for pediatric care, child health trusts, community-accountable child health development systems, and an early life course infrastructure are among the innovations that could help transform pediatric health care.
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From page 16... ...
Halfon also noted that when child development data are mapped against police data, law enforcement can see that the two are linked and begin to think more about how upstream policing may be an effective crime prevention strategy. In response to an analogy drawn by a workshop participant between the current situation and early public health campaigns to provide clean water and sanitation to communities and households, Halfon pointed to four factors that were critical to the success of those early campaigns.
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From page 17... ...
Reducing the big cost drivers in health, such as diabetes and heart disease, requires a safe, healthy, and supportive community environment, he said. This requires encompassing behavioral health issues as well as the traditional chronic physical conditions.
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A report from the National Prevention Council, cleared by all the members of the council, laid out a very expansive vision for the goals, strategic directions, and priorities of a National Prevention Strategy, Levi noted. The strategy rests on four major goals: healthy and safe community environments, clinical and community preventive services, elimination of health disparities, and empowered people.
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, it can take expected savings and invest in new programs, such as an outpatient oral health clinic and a sobering center. "They've been able to capture savings, they've been able to reinvest, and they've been able to show that providing this broad range of services can be helpful both on the health side and on the social services side." CMS is now interested in testing this approach in more complex political structures.
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From page 20... ...
2014c. The changing nature of children's health development: new challenges require major policy solutions.
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From page 21... ...
2014. "The Life Course Health Development Model." Web.
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