Child Health

As children grow, they develop skills that impact the rest of their lives. We created initiatives and programs to build systems that improve the physical and emotional health of children and adolescents.

These efforts promote best-in-class emergency medical care for children and encourage positive parenting, child development, and school readiness.

What are our goals?

Increase the number of children who receive a developmental screening.

Early identification of developmental disorders is critical to the well-being of children and their families. The American Academy of Pediatrics (AAP) recommends screening tests begin at the nine-month visit.

Decrease the number of hospital admissions for non-fatal injury among children ages zero through nine.

Reducing the burden of non-fatal injury can greatly improve the quality of life and cost savings for children and their families.

Decrease the number of sleep-related deaths.

The AAP recommends use of the back-sleep position on a separate firm sleep surface and without loose bedding

Decrease bullying victimization among children and adolescents.

Emotional and behavioral problems experienced by victims, bullies, and bully-victims may continue into adulthood and produce long-term negative outcomes

Increase the number of children who are adequately insured.

Inadequately insured children are more likely to lack appropriate and timely care, be without a medical home and/or dental home, and be less likely to receive needed referrals and family-centered care.

Increase access to comprehensive oral health care for MCH populations most at risk for oral disease.

One in four women of childbearing age have untreated cavities. Children from mothers with poor oral health develop tooth decay at a higher rate with one in five affected in early childhood.
When left untreated, tooth decay can harm children’s quality of life and impair academic performance.
Moreover, parents averaged 2.5 absent days from work or school per year because of their children's dental problems.

How do we accomplish our goals?

We accomplish our goals through the following initiatives and programs:

Child Safety Learning Collaborative

We partner with other federal agencies and more than 20 national organizations to reduce fatal and serious injuries among infants, children, and youth. Through the Child Safety Learning Collaborative, states and jurisdictions are working with one another to increase the adoption of evidence-based policies, programs, and practices at state and local levels.

It supports shared improvement among Title V agencies in 15 states on the following:
- Sudden unexpected infant deaths (SUID)
- Bullying prevention
- Suicide/self-harm prevention
- Motor vehicle traffic
National Fetal, Infant, and Child Death Review Program
- We fund the National Center for Fatality Review and Prevention to provide leadership, technical assistance and training to more than 1350 state and local Child Death Review (CDR) teams as well as 175 Fetal and infant mortality reviews programs (FIMRs). The Center also helps these programs facilitate the translation of recommendations from CDR and FIMR into action and practice.
- The Center created and maintains a standardized data collection form and a cost-free National Case Reporting System for CDR and FIMR programs. The system contains entries on more than 230,000 child deaths from 45 states and more than 6,090 FIMR cases from 19 states. The data from these reviews provide insight into gaps in services, systems, and modifiable risk factors. This helps create and maintain risk reduction and prevention programs at the local, state and federal level.
- The Healthy Start program also directly funds some localities to create FIMR programs to raise awareness of fetal, and infant deaths, prevent future deaths, and address emerging issues.
National Action Partnership to Promote Safe Sleep Improvement and Innovations Network (NAPPSS-IIN)
NAPPSS-IIN is an initiative to make safe infant sleep and breastfeeding the national norm by aligning stakeholders in a coalition of organizations that work with families. NAPPSS-IIN is also testing safety bundles in multiple care settings to improve the likelihood that infant caregivers and families receive consistent, evidence-based instruction about safe sleep and breastfeeding.
HRSA Bullying Prevention Initiative
Approximately 20% of youth ages 12 through 18 reported being bullied at school in the United States during the 2017 school year. That translates to millions of youth being impacted across the country each year.In 2017, about 29 percent of 6th-graders, 25 percent of 8th-graders, and 24 percent of 7th-graders reported being bullied at school, In addition, a higher percentage of 9th-graders than of 11th- and 12th-graders and a higher percentage of 10th-graders than of 12th-graders reported being bullied at school (PDF - 2 MB)

Research shows bullying has serious, lasting effects. But prevention can improve the physical and mental health, safety, and well-being of children and their families.

Our program works with stakeholders at national, state, and local levels to translate research and develop guidance and resources. We then share these via StopBullying.gov.
Early Childhood Comprehensive Systems (ECCS)
Bridging the Word Gap Research Network
Its goal is to reduce the number of children who enter school with delays in language and early literacy.

Emergency Medical Services for Children (EMSC)

EMSC is the only federal grant program specifically focused on addressing the distinct needs of children in pre-hospital and hospital emergency medical systems. The program works to ensure that seriously sick or injured children have access to the same high-quality pediatric emergency health care no matter where they live in the United States.

The Program has five main investments to ensure pre-hospital EMS agencies and hospital emergency departments improve pediatric health outcomes:
- Pediatric Emergency Care Applied Research Network
  Conducts rigorous multi-institutional research in Emergency Department and pre-hospital EMS settings. Seeks to increase the evidence base for appropriate and effective treatment that improves health outcomes for acute illnesses and injuries in children.
- State Partnership
  Expands and improves a state's capacity to deliver evidence-based, effective pediatric emergency care that aligns with best practices. Awardees in states and schools of medicine are driving system improvements in nine pediatric-focus areas.
- Targeted Issues
  Supports investigator-driven research and innovative projects that turn research into practice and contributes to the evidence base for improving pediatric health outcomes related to emergency care.
- EMSC Data Center
  Serves two major functions:
  1. Supports states in the collection, analysis, and utilization of data for EMSC performance measures, as well as provides analytical support to award recipients and national stakeholders to advance the delivery of quality pediatric emergency care; and
  2. Serves as an independent Data Coordinating Center for the Pediatric Emergency Care Applied Research Network (PECARN), a research network conducting rigorous, high priority research studies.
- EMSC Innovation and Improvement Center
  Accelerates improvements in quality of care and outcomes for children who are in need of urgent or emergency care through an infrastructure that ensures routine, integrated coordination of quality improvement activities between key stakeholder organizations and their champions. The center works to demonstrate how leveraging quality improvement science can improve and transform health care outcomes for children in the United States.

Oral Health Program

The OHP investments address the distinct oral health needs of pregnant women, infants, children, and adolescents, including children with special health care needs, and their families. OHP works to ensure that all MCH populations have access to the same high-quality preventive oral health services within existing MCH systems of care, no matter where they live in the United States. OHP invests in two strategies to improve systems change: (1) testing innovations to build evidence around specific strategies for improving oral health, and (2) providing individualized technical assistance (TA) to state and local stakeholders. These investments include:
- National Maternal and Child Center for Oral Health Systems Integration and Improvement (COHSII) - The COHSII consortiumpromotes oral health knowledge and skills among key stakeholders, serving as a center of excellence in oral health technical assistance, training, and resource development. The National Maternal and Child Oral Health Resource Center (OHRC), leads the COHSII consortium, serving the educational and training needs of health professionals, program administrators, educators, and others working in or with MCH programs by providing easy access to reliable oral health resources, including the following resources accessible on the OHRC website:
  - Title V MCH Services Block Grant Oral Health Toolkit
  - Oral Health Care During Pregnancy: A National Consensus Statement
  - Bright Futures Oral Health Pocket Guide
  - Special Care: An Oral Health Professional’s Guide to Serving Children with Special Health Care Needs
  - Networks for Oral Health Integration Within the Maternal and Child Health Safety Net (NOHI) - The purpose of the NOHI is to improve access to and delivery of comprehensive, quality oral health care for infants and children by testing and establishing models of care utilizing three collective strategies:
    1. enhanced integration of oral health care within MCH safety net services;
    2. increased in knowledge and skills among health professionals, both dental and non-dental; and
    3. increase in knowledge and awareness of preventive oral health practices among parents and other caregivers. OHP is funding three NOHI networks, each comprised of nearly 20 MCH safety net sites located across four different states.
  - Oral Health Quality Indicators for the Maternal and Child Health Population - COHSII’s Quality Indicators Advisory Team (QIAT) has established a first-of-its-kind set of maternal and child oral health quality indicators. The QIAT efforts include the development of a user guide (PDF - 1 MB) and a feasibility assessment tool.