Beyond ABC

Beyond ABC: Assessing Children's Health in Dallas County aims to offer a foundation for understanding the socioeconomic and health issues children in Dallas County face.

The number of Dallas County children with some form of insurance has increased, but other troubling trends continue in the health, economic security, safety and education of local youth, according to a new report from UT Dallas and Children’s Medical Center.

Researchers at UT Dallas’ Institute for Urban Policy Research compiled the data for the 2013 report, Beyond ABC: Assessing Children’s Health in Dallas County. The 12th edition of the report focuses exclusively on children in Dallas County and aims to offer a foundation for understanding the socioeconomic and health issues they face.

Dr. Timothy Bray, director of the Institute and faculty member in the School of Economic, Political and Policy Sciences, joined a panel discussion Nov. 12 at Children’s Medical Center in Dallas. He spoke about the yearlong efforts by the advisory board to establish 61 indicators for the institute to evaluate.

Dr. Timothy Bray

“Men and women who work every day with folks who face the burdens of illness, the burdens of poverty, many of the conditions that we describe in this book – without their insight, the numbers are just numbers,” Bray said of the board. “One of the challenges is taking 61 indicators that by themselves are staggering and realizing what it means when they all come together.”

On a positive note, Dallas County has fewer uninsured children: 13.4 percent in 2012, an improvement from 25 percent in 2008, but that figure is still nearly double the national average of 7.2 percent.

The steep decline in uninsured children is accompanied by dramatic increases in children’s Medicaid and CHIP (Children’s Health Insurance Program) enrollment, suggesting that government programs are closing the gap. More Dallas County children than ever – 292,398 – were enrolled in Medicaid in 2012.

But more than 90,000 Dallas County children remain without health insurance.

“When we talk about families where both parents work, remember with some of these families, not only do they work, they work two or three or four jobs, which don’t offer health insurance,” Bray said. “… If they have to stay home with a sick kid, they have to make the choice of, ‘Do I want my paycheck or do I want to be with my child?’”

Nearly 30 percent of Dallas County children were living in poverty in 2012, far greater than the national average of 22 percent. The percentage has risen 6 points in the past decade and has remained unchanged for the last three years.

In the city of Dallas, 37.6 percent of all children lived below the poverty line ($23,550 per year for a family of four). More than 172,600 Dallas County children live in households without enough food.

“While we talk about 1 in 3 children living in poverty, there are neighborhoods where every child lives in poverty,” Bray said. “… If you go to a neighborhood where 40 or 50 percent of children don’t have a medical home (patient-centered primary health care), everything else begins to fall like dominos.

“Health isn’t just about sick kids; mostly, it’s about well kids,” he added. “It’s your medical home that can help diagnose a developmental delay with a child and route you to the right early childhood intervention program so a kid goes into kindergarten able to read, or … goes into kindergarten speaking.”