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For the last 25 years, the Harris County Child Fatality Review Team (HCCFRT) has met regularly to carefully examine every non-natural child fatality occurring in Harris County to find gaps in policy and practice that can lead to the future prevention of child deaths. The HCCFRT is a cross-sector collaboration with members from a variety of agencies and organizations across Harris County, Texas. This report details findings from analysis of the 2,260 non-natural child deaths reviewed over a 10-year period, 2008-2017. Overall, there has been a 35% decrease in non-natural child fatalities over the decade. The three leading causes of non-natural deaths for children in Harris County were: Infant sleep-related deaths (32%), motor vehicle collisions (MVCs, 18.6%), and firearm-related deaths (13.8%).
The goal of this blueprint is to propose a practice model which builds upon the trusted relationship between pediatric practices and the children and families they care for that will help families build strong foundations for lifelong health and learning. This practice model does not ask the pediatrician solely to do more; rather it expands the scope of the practice as a whole from traditional medical care (immunizations, well-child checkups, minor illnesses) to encompass parenting and child development, behavioral health, select family medical care, social determinants of health (SDH), and community engagement in order to provide more comprehensive, impactful care.
In Texas, drug overdose is now the leading cause of maternal mortality, with opioids involved in the majority (58%) of maternal deaths within 1 year of delivery. Rates of prenatal drug exposure and infants experiencing withdrawal symptoms due to prenatal drug exposure have dramatically increased over the last decade. In December 2017, Public Health Pediatrics received funding from the Center for Drug Policy and Enforcement at University of Baltimore through the Combating Opioid Overdose through Community-level Intervention (COOCLI) Initiative. During the first year of the project, the team conducted an assessment of perinatal opioid use within two large cities in Texas, Houston and San Antonio. During this assessment the team: formed a collaborative in each city to bring together stakeholders from each sector involved (law enforcement, justice, treatment, child welfare, and healthcare); interviewed stakeholders across sectors to understand the policies and practices that dictate how each sector responds to perinatal opioid use and how sectors interact with one another in response to perinatal opioid use; developed recommendations to improve the community’s response to perinatal opioid use; and conducted a readiness and implementation assessment to help prioritize recommendations based on local needs and resources.
Seven percent of children in Harris County have a parent in the Harris County Jail each year and the majority of these children are not receiving needed services despite the trauma, parental separation, and financial hardship that often accompanies parental incarceration. In collaboration with the Harris County Sheriff’s Office and the University of Texas Medical Branch we conducted a needs assessment to better understand the needs of children with incarcerated parents in our community. The needs assessment included a literature review, interviews with inmates at the Harris County Jail, interviews with caregivers of children with incarcerated parents, and analysis of Harris County Jail data.
This report provides an overview of our findings and recommendations on how our community can better support the 92,000+ children in our county that have a parent in the Harris County Jail each year.
Food insecurity impacts millions of Americans each year. It occurs when households do not have reliable access to nutritionally adequate or safe foods.
There are an estimated 724,750 food insecure individuals in Harris County with a food insecurity rate of 16.6%. Among children, the rate of food insecurity is 23.6%. Food insecurity can have significant negative implications on a person’s health, including higher rates of chronic diseases and mental health problems.
This report provides healthcare providers with information on how to integrate food insecurity screening into their practice and how to respond to a positive screen, including a list of local resources. The report also highlights the need for more research on food insecurity screening and interventions and how to most effectively reduce rates of food insecurity and improve patient outcomes.
An Assessment of Screening for Intimate Partner Violence
Intimate partner violence is a pattern of behavior used to establish power and control over someone through fear and intimidation and may include physical, sexual, emotional, or financial abuse. Survivors of intimate partner violence access healthcare at greater rates than the general public and it is recommended that healthcare providers screen for intimate partner violence. This report provides an overview on screening for intimate partner violence, including perspectives from survivors, and recommendations on how healthcare providers can improve screening for intimate partner violence.