California Report Card 2003
Focus on Children's Health, November 2003

California Report Card 2003
This 52-page report provides an overview of issues facing California's children, with special focus on health.
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Introduction
California boasts a wealth of health care resources. Yet despite world-renowned hospitals, biotechnology industry innovators and leading research labs, 1.2 million children lack basic health insurance, and even more lack coverage for oral health care. With 88,000 farms, California leads the nation in food production, yet few California schoolchildren eat fresh fruit and vegetables at lunch each day.

Moreover, many children even go hungry, particularly in some of the state's most agricultural counties. Over one million children in California have been diagnosed with asthma, and nearly one million children ages 2-11 have never been to a dentist. In all areas of health and health care, California children are vulnerable: substantial disparities persist by region, by ethnicity, by immigration status and by income.

A child's health derives from a complex mix of individual, family and community factors and the public policy environments in which they interact. In the case of a child with asthma, for instance, current evidence points to several conditions that can lead to development of the disease, including genetic susceptibility, low birthweight, inadequate housing and nutrition, and air pollution. Having access to health care and following prescribed treatments make a difference in an asthmatic child's quality of life. On a larger scale, public policy decisions affect the causes of asthma, the environments in which asthmatic children must manage their condition, and the quality of care children receive.

This year's California Report Card focuses on some of the central issues in children's health, including infant health, health insurance and access to care, oral health, nutrition and physical fitness, and mental health. The release of data from UCLA's California Health Interview Survey (CHIS), the largest state health survey ever conducted in the U.S. with over 50,000 respondents, gives us a wealth of new information on children's health behaviors and outcomes.

This knowledge coincides with an economic crisis that threatens gains the state has made in improving children's health. The size of the state budget deficit is unprecedented; federal tax cuts limit the resources California can draw upon; and public health programs and private hospitals alike are staggering under the combined burdens of cost escalations, increased demand for services and budget cuts. Nevertheless, there are great opportunities for progress in improving children's health.

Historically, political movements to expand children's access to insurance and services have garnered bipartisan agreement. In recent years, the development of the State Children's Health Insurance Program (Healthy Families in California) at the federal and state levels, eligibility expansions in Medi-Cal, the state's Medicaid program, and the development of the Family PACT program and other services, have been the result of hard work by policy-makers from both parties. We know that the public will and political will are there. Even in these difficult times, we must continue to move forward on children's health issues. California's public policies must ensure that all children have access to high-quality medical, oral and mental health care, and create an atmosphere that emphasizes prevention and makes healthy lifestyle choices easy. The stakes--for children, their communities and the state--are simply too high.