Counting down children's health

Since setting up his practice at Cross Trails Medical Center in Marble Hill, Mo., Dr. Phil Greene has seen pregnant teenagers come and go.

He's seen a child who was molested by an HIV-positive father. He's thrown his hands up in frustration at being able to do so little to stop the abuse of that child and a long line of others.

He's seen patients who refuse life-saving treatment for themselves and their children. Greene has seen all that in just five months of practicing medicine in the rural county.

All of it -- the abuse, lack of health care, teen pregnancy -- are factors in the poor health and welfare of children.

According to Kids Count 2004, a compilation of county-by-county data released every January by Citizens for Missouri's Children, Bollinger County ranks 82nd among 114 Missouri counties for child well-being.

Like the surrounding counties of Cape Girardeau and Scott, Bollinger fell several spots in ranking this year, down from 69th in 2003. Cape Girardeau County was 23rd in 2003 and 29th this year. Scott County fell from 88th to 94th.

Charlotte Craig, director of the Cape Girardeau County Public Health Center, said her facility uses the annual report as the basis for research and grants.

"One responsibility of the public health department is to periodically assess the community," Craig said. "This is one way to do it."

However, Craig said it's important to note that the Kids Count data runs a year behind. The 2004 Kids Count report contains data from 2003. Because of that, the trends may not actually reflect what's happening now.

"For example, teen pregnancies and births. We believe they are down not just here but even statewide," Craig said. "Our teens are much better educated now."

Health officials in Bollinger County have not fared as well in the war against teenage pregnancies and other indicators in the Kids Count report.

Bollinger County Health Department administrator Beverly Piepenbrok reviews the Kids Count data each year, studying trends and rankings. This year, Bollinger actually improved in seven of the 10 data indicators used in the report but still fared poorly in areas such as annual high school dropouts, in which it merited a state ranking of 108, and infant mortality, in which Bollinger County ranked 97th.

"We don't want it hidden, we want it reported," Piepenbrok said. "The problems identified are being looked at, but these are problems that have developed over years and years."

Scott County's problem areas this year were low birth weight infants, a 108th ranking; infant mortality, 107th ranking; and births to teenagers, 108th ranking.

"Those tend to be our problems every year, it's not anything new," said Kay Griffin, Women's Healthcare nurse practitioner at the Scott County Health Center. "It really all stems back to teenage pregnancy."

The county health center has several programs already in place to prevent teenage pregnancy and also to provide support to pregnant teenagers.

There's a family planning clinic, case management for pregnant teens and WIC, a federal program that serves low-income women, infants, and children with nutritious foods, information on healthy eating and referrals to health care.

"We know that children who have low birth weight may have weaker immune systems," Griffin said. "And the long-term effects of teen pregnancies are well known: Mom doesn't finish school, doesn't get a good job, stays on Medicaid."

The same is true in Bollinger County.

"We have 13-, 14-year-old girls come in and say, 'My goal is to have a kid,'" said Dr. Edward Doyle, physician and medical director at Cross Trails in Marble Hill. "They're trying to get out of a situation or trying to find unconditional love."

Cross Trails is Bollinger County's only health-care facility. The center offers a sliding scale payment plan that gives discounts of up to 75 percent to low-income families who don't have insurance. Doyle and his staff go to great lengths to insure that patients have the needed care.

They find transportation, even awarding gas vouchers, if a patient doesn't have a ride. They offer a medication program in conjunction with pharmaceutical companies that gives patients free prescriptions.

But people are still turned away every day because of an overload. Others may need treatment but refuse to see a doctor.

"Input from something like this Kids Count report makes us more aware of what we should focus on," Doyle said.

cclark@semissourian.com

335-6611, ext. 128

KIDS COUNT'S LOCAL NUMBERS

KIDS COUNT'S LOCAL NUMBERS

Counties in Southeast Missouri have fallen in rankings of how they provide for children's well-being. Rankings show how each county stands among the state's 114 counties.

STATE RANKING (OF 114 COUNTIES)

CAPE GIRARDEAU COUNTY

Low-income students 16

Births to mothers without high school diploma 31

Low birthweight infants 59

Infant mortality 71

Child deaths (ages 1-14) 25

Child abuse/neglect 39

Out of home placement 44

Annual high school dropouts 75

Births to teens 26

Violent deaths (ages 15-19) 8

BOLLINGER COUNTY

Low-income students 64

Births to mothers without high school diploma 57

Low birthweight infants 36

Infant mortality 97

Child deaths (ages 1-14) 9

Child abuse/neglect 36

Out of home placement 16

Annual high school dropouts 108

Births to teens 80

Violent deaths (ages 15-19) 13

SCOTT COUNTY

Low-income students 80

Births to mothers without high school diploma 87

Low birthweight infants 108

Infant mortality 107

Child deaths (ages 1-14) 93

Child abuse/neglect 79

Out of home placement 52

Annual high school dropouts 18

Births to teens 108

Violent deaths (ages 15-19) 47

SOURCE:Citizens for Missouri's Children Southeast Missourian