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What's in the Child and Maternal Health section? Are We Making Smart Investments? Screening and identification; Parent education; Health care access; Obesity prevention Are We Advancing the Health of All Children? Race and ethnicity Keeping Children Safe from Environmental Toxins - Secondhand smoke; Methylmercury; Lead; Bisphenol A; Air quality Promoting the Health of Mothers to Be - Prenatal Care; Maternal substance abuse; Preventing teen births Giving Babies the Right Start in Life - Low birthweight; Infant mortality; Preventing prematurity and delivery trauma; Breastfeeding; SIDS Supporting Fit and Healthy Kids - Child obesity rates and costs; Access to healthy foods; Complete streets; Health education; Promoting health in schools and child care settings; Fitness and academics Helping Children in Texas Drink Well - Access to water and milk in school and child care settings; Taxing sugary drinks Child and Maternal Health-Child Mental Wellbeing Bridge: Connecting Children to Health and Mental Health Care - Medicaid; CHIP; Health insurance reform; Mental health parity Download the Child and Maternal Health section of A Report on the Bottom Line: Conditions for Children and the Texas of Tomorrow. Child and Maternal Health Sources 1 From: A Year of the Infant Health Alliance: Resources, Take-Aways, and Recommendations, 3.2009: An Overview of Infant Health in Texas, Speaker: Brian Castrucci, Texas Department of State Health Services 2 From: A Year of the Infant Health Alliance: Resources, Take-Aways, and Recommendations, 3.2009: An Overview of Infant Health in Texas, Speaker: Brian Castrucci, Texas Department of State Health Services 3 "Developmental Screening of Infants and Toddlers." Achieving the Promise of a Bright Future. Zero to Three: National Center for Infants, Toddlers, and Families, 2009. 4 Steve Aos, Roxanne Lieb, Jim Mayfield, Marna Miller, and Annie Pennucci, Benefits and Costs of Prevention and Early Intervention Programs for Youth, (Olympia, WA: Washington State Institute for Public Policy, 2004), p. 4, http://www.wsipp.wa.gov/rptfiles/04-07-3901.pdf. 5 "What is Parents as Teachers," Parents as Teachers Texas, http://www.txpat.org/, accessed March 29, 2010. 6 Parents as Teachers Research and Program Quality, Parents as Teachers National Center, http://www.parentsasteachers.org/images/stories/documents/Research_Quality_Booklet.pdf. 7 "Parents as Teachers," Child Trends Guide to Effective Programs for Children and Youth, http://www.childtrends.org/Lifecourse/programs/ParentsAsTeachers(PAT).htm, accessed March 29, 2010. 8 "Program Sites," Texas Parents as Teachers, http://txpat.org/roster1_1.htm, accessed March 29, 2010. 9 Steve Aos, Roxanne Lieb, Jim Mayfield, Marna Miller, and Annie Pennucci, Benefits and Costs of Prevention and Early Intervention Programs for Youth, (Olympia, WA: Washington State Institute for Public Policy, 2004), p. 4, http://www.wsipp.wa.gov/rptfiles/04-07-3901.pdf. 10 Steve Aos, Roxanne Lieb, Jim Mayfield, Marna Miller, and Annie Pennucci, Benefits and Costs of Prevention and Early Intervention Programs for Youth, (Olympia, WA: Washington State Institute for Public Policy, 2004), p. 4, http://www.wsipp.wa.gov/rptfiles/04-07-3901.pdf. 11 Nurse Family Partnership," State Profile 2010: Texas, http://www.nursefamilypartnership.org/communities/state-profiles, accessed March 29, 2010. 12 "Proven Results," Nurse Family Partnership, http://www.nursefamilypartnership.org/proven-results, accessed March 29, 2010. 13 Steve Aos, Roxanne Lieb, Jim Mayfield, Marna Miller, and Annie Pennucci, Benefits and Costs of Prevention and Early Intervention Programs for Youth, (Olympia, WA: Washington State Institute for Public Policy, 2004), p. 4, http://www.wsipp.wa.gov/rptfiles/04-07-3901.pdf. 14 From: A Year of the Infant Health Alliance: Resources, Take-Aways, and Recommendations, 2.2010: Preventing preterm and low birthweight births. Speakers: Morgan Sanders, March of Dimes 15 CPPP, "Texas Health Care Primer," November, 2003, p. 47. 16 Children's Defense Fund. In Harm's Way. Houston, 2009. 17 Susan Combs, Texas Comptroller of Public Accounts, "Weighing the Costs," Special Report: Counting Costs and Calories: Measuring the Cost of Obesity to Texas Employers, March 2007, http://www.window.state.tx.us/specialrpt/obesitycost/05weighingcosts.html. 18 Susan Combs, Texas Comptroller of Public Accounts, "Today's Children, Tomorrow's Workforce," Special Report: Counting Costs and Calories: Measuring the Cost of Obesity to Texas Employers, March 2007, http://www.window.state.tx.us/specialrpt/obesitycost/09todaytomorrow.html. 19 Texas Department Health, The Burden of Overweight & Obesity in Texas, 2000-2040, http://www.dshs.state.tx.us/obesity/pdf/Cost_Obesity_Report.pdf. 20 U.S. Centers for Disease Control and Prevention, "Make a Difference at Your School", 2008. http://www.cdc.gov/HealthyYouth/keystrategies/pdf/make-a-difference.pdf Accessed August, 2010. 21 "Coordinated Approach to Child Health: Program History," CATCH Texas, http://www.sph.uth.tmc.edu/catch/about_History.htm. 22 Henry Shelton Brown III, Adriana Perez, Yen-Peng Li, Deanna M. Hoelscher, Steven H. Kelder, and Roberto Rivera, "The Cost-Effectiveness of a School-Based Overweight Program," International Journal of Behavioral Nurtition and Physical Activity, 4, no. 47, 2007, p. doi: 10.1186/1479. 23 Fact Sheet: Overweight and Obesity Among Latino Youths, (Princeton, NJ: Robert Wood Johnson Foundation, May 2010), http://www.rwjf.org/files/research/20100512lhclatino.pdf. 24 Texas Department Health, The Burden of Overweight & Obesity in Texas, 2000-2040, http://www.dshs.state.tx.us/obesity/pdf/Cost_Obesity_Report.pdf. 25 Texas Department Health, The Burden of Overweight & Obesity in Texas, 2000-2040, http://www.dshs.state.tx.us/obesity/pdf/Cost_Obesity_Report.pdf. 26 Fact Sheet: Overweight and Obesity Among Latino Youths, (Princeton, NJ: Robert Wood Johnson Foundation, May 2010), http://www.rwjf.org/files/research/20100512lhclatino.pdf. 27 Fact Sheet: Overweight and Obesity Among Latino Youths, (Princeton, NJ: Robert Wood Johnson Foundation, May 2010), http://www.rwjf.org/files/research/20100512lhclatino.pdf. 28 Fact Sheet: Overweight and Obesity Among African-American Youths, (Princeton, NJ: Robert Wood Johnson Foundation, May 2010), http://www.rwjf.org/files/research/20100512lhcafricanamerican.pdf. 29 2007 National Survey of Children's Health Data Resource Center, http://www.nschdata.org/DataQuery/DataQueryResults.aspx. 30 Miguel Lausell, "In America's Food Deserts,' it's a Nutrition Nightmare," Times Herald-Record Online, May 4, 2010, http://www.recordonline.com/apps/pbcs.dll/article?AID=/20100504/OPINION/5040308/-1/SITEMAP. 31 Fact Sheet: Overweight and Obesity Among African-American Youths, (Princeton, NJ: Robert Wood Johnson Foundation, May 2010), http://www.rwjf.org/files/research/20100512lhcafricanamerican.pdf. 32 Fact Sheet: Overweight and Obesity Among African-American Youths, (Princeton, NJ: Robert Wood Johnson Foundation, May 2010), http://www.rwjf.org/files/research/20100512lhcafricanamerican.pdf. 33 Feeding America, "The Implications of Food Insecurity for Children," http://feedingamerica.org/faces-ofhunger/hunger-101/child-hunger-implications.aspx#_ednref3.f 34 Texas Department of State Health Services, Health Status Indicators by Race/Ethnicity for the State of Texas and Each of its Public Health Regions (PHRs), 2005, http://www.dshs.state.tx.us/chs/pubs/healthy/hptx2000.pdf. 35 Data is from 2006. Texas Health Data, Center for Health Statistics, Texas Department of State Health Services. Available: http://www.dshs.state.tx.us/chs/default.shtm. Accessed 11/2009. 36 The State of Infant Health in Texas," p. 36. Source of Data: Texas Department of State Health Services Mortality and Natality Files 1996-2005. 37 Data is from 2006. Texas Health Data, Center for Health Statistics, Texas Department of State Health Services. Available: http://soupfin.tdh.state.tx.us/ under "Birth." Accessed 4/2010.s 38 Schempf AH, Branum AM, Lukacs SL, Schoendorf, KC. The contribution of preterm birth to the black-white infant mortality gap, 1990 and 2000. Am J Public Health. 2007;97(7): 1255-C1260. 39 Ibid.,1255-C1260. 40 Alexander GR, Wingate MS, Bader D, Kogan MD: The increasing racial disparity in infant mortality rates: Composition and contributors to recent US trends. Am J Obstet Gynecol 2008;198:51.e1-51.e9. 41 Ibid., 51.e1-51.e9. 42 CDC "Neonatal intensive-care unit admission of infants with very low birth weight -- 19 states, 2006" MMWR 2010; 59: 1444-1447. 43 Ibid., 1444-1447. 44 Office of the Surgeon General, "Children are Hurt by Secondhand Smoke," The Health Consequences of the Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US Department of Health and Human Services, http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet2.html, accessed March 22, 2010. 45 Office of the Surgeon General, "Children are Hurt by Secondhand Smoke," The Health Consequences of the Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US Department of Health and Human Services, http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet2.html, accessed March 22, 2010. 46 Office of the Surgeon General, "Children are Hurt by Secondhand Smoke," The Health Consequences of the Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US Department of Health and Human Services, http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet2.html, accessed March 22, 2010. 47 Office of the Surgeon General, "Secondhand Smoke Exposure in the Home," The Health Consequences of the Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US Department of Health and Human Services, http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet4.html, accessed March 22, 2010. 48 "SLATI (State Legislated Actions on Tobacco Issues) State Information: Texas," American Lung Association, http://slati.lungusa.org/state-teml.asp?id=43, accessed March 22, 2010. 49 Office of the Surgeon General, "Secondhand Smoke Exposure in the Home," The Health Consequences of the Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US Department of Health and Human Services, http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet4.html, accessed March 22, 2010. 50 "ToxFAQs for Mercury," Agency for Toxic Substances and Disease Registry, http://www.atsdr.cdc.gov/tfacts46.html. 51 "Frequently Asked Questions About Mercury and Thimerosol." Centers for Disease Control and Prevention. Available: http://www.cdc.gov/vaccinesafety/updates/thimerosal_faqs_mercury.htm. Accessed 12/2009. 52 "What You Need to Know About Mercury in Fish and Shellfish." United States Environmental Protection Agency. Available: http://www.epa.gov/fishadvisories/advice/#what. Accessed 1/2010 53 "What You Need to Know About Mercury in Fish and Shellfish." United States Environmental Protection Agency. Available: http://www.epa.gov/fishadvisories/advice/#what. Accessed 1/2010. 54 Texas Childhood Lead Poisoning Prevention Program, Lead Exposure in Texas Fact Sheet 55 "Texas Childhood Lead Poisoning Prevention Program: Basic Information," Texas Department of State Health Services, http://www.dshs.state.tx.us/lead/Basic%20Information.shtm, (accessed March 4, 2010). 56 "Bisphenol A (BPA) Information for Parents," US Department of Health and Human Services, http://www.hhs.gov/safety/bpa/, accessed March 22, 2010. 57 John M. Broder, "New E.P.A. Scrutiny Is Set for a Chemical in Plastics," New York Times, March 29, 2010, http://www.nytimes.com/2010/03/30/science/earth/30epa.html. 58 "Bisphenol A (BPA) Information for Parents," US Department of Health and Human Services, http://www.hhs.gov/safety/bpa/, accessed March 22, 2010. 59 "Update on Bisphenol A (BPA) for Use in Food: January 2010," US Food and Drug Administration, http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm064437.htm, accessed March 22, 2010. 60 "Bisphenol A (BPA) Information for Parents," US Department of Health and Human Services, http://www.hhs.gov/safety/bpa/, accessed March 22, 2010. 61 John M. Broder, "New E.P.A. Scrutiny Is Set for a Chemical in Plastics," New York Times, March 29, 2010, http://www.nytimes.com/2010/03/30/science/earth/30epa.html. 62 Texas Commission on Environmental Quality, "Sources of Air Pollution," http://www.tceq.state.tx.us/implementation/air/areasource/Sources_of_Air_Pollution.html, accessed March 25, 2010. 63 Drive Clean Across Texas, "Air Quality Facts: Air Pollutants and their Effects," http://www.drivecleanacrosstexas.org/facts/, accessed March 25, 2010. 64 Office of the Surgeon General, "How to Protect Yourself and Your Loved Ones from Secondhand Smoke," The Health Consequences of the Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US Department of Health and Human Services, http://www.surgeongeneral.gov/library/secondhandsmoke/factsheets/factsheet3.html , accessed March 22, 2010. 65"What is Prenatal Care/Preconception Care?," The Eunice Kennedy Shriver National Institute of Child Health and Human Development, http://www.nichd.nih.gov/health/topics/preconception_care.cfm. 66 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, (Austin: Center for Public Policy Priorities, 2009), www.cppp.org/factbook08. 67 The rate is 2 out of 5 among African-Americans and Hispanics. Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, (Austin: Center for Public Policy Priorities, 2009), www.cppp.org/factbook08. 68 "Pregnancy and Newborn Health Education Center: Prenatal Care," March of Dimes, http://www.marchofdimes.com/pnhec/159_513.asp. 69 "Texas Vital Statistics," Texas Department of Health (TDH), Bureau of Vital Statistics, Annual Reports 2001, http://www.tdh.state.tx.us/bvs/stats01/annr_htm/01summ.htm. 70 Eric A. Miller, Texas Pregnancy Risk Assessment Monitoring System Annual Report 2004 (PRAMS), (Austin, TX: Division of Family and Community Health Services, Texas Department of State Health Services, 2004), http://www.dshs.state.tx.us/mch/pdf/PRAMS%20annual%2004.pdf. 71 Kate Sullivan, 2007 Annual Report: Texas Pregnancy Risk Assessment Monitoring System (PRAMS), (Austin, TX: Division of Family and Community Health Services, Texas Department of State Health Services, 2010), http://www.dshs.state.tx.us/mch/pdf/2007%20PRAMS%20Annual%20Report.pdf. 72 Tom Phelps, "Prenatal Care," (address, Texas Infant Health Alliance, Any Baby Can, Austin, November 18, 2009). 73 "The Centering Pregnancy Model," March of Dimes, http://www.marchofdimes.com/files/The_Centering_Model.pdf. 74 Deborah S. Walker and Renee Worrell, "Promoting Healthy Pregnancies Through Perinatal Groups: A Comparison of CenteringPregnancy® Group Prenatal Care and Childbirth Education Classes," Journal of Perinatal Education, 17, no.1, Winter 2008, 27-34. 75 "Low Birthweight in Newborns," Children's Hospital Boston, http://www.childrenshospital.org/az/Site1247/mainpageS1247P0.html. 76 "Fetal alcohol spectrum disorders are 100% preventable," Centers for Disease Control and Prevention, http://www.cdc.gov/Features/FASD/. 77 "FASD Prevention Task Force," Texas Office for Prevention of Developmental Disabilities http://www.topdd.state.tx.us/fasdprevention.php. 78 "Fetal Alcohol Spectrum Disorders," Centers for Disease Control and Prevention, http://www.cdc.gov/ncbddd/fasd/data.html. 79 "State-specific Alcohol Consumption Rates for 2008," Centers for Disease Control and Prevention, http://www.cdc.gov/ncbddd/fasd/monitor_table2008.html. 80 Kate Sullivan, 2007 Annual Report: Texas Pregnancy Risk Assessment Monitoring System (PRAMS), (Austin, TX: Division of Family and Community Health Services, Texas Department of State Health Services, 2010), http://www.dshs.state.tx.us/mch/pdf/2007%20PRAMS%20Annual%20Report.pdf. 81 "Surveillance for Disparities in Maternal Health-Related Behaviors: Selected States, Pregnancy Risk Assessment Monitoring System (PRAMS) 2000-2001," Centers for Disease Control and Prevention, July 2004. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5304a1.htm. 82 "Smoking During Pregnancy," Centers for Disease Control and Prevention, http://www.cdc.gov/tobacco/basic_information/health_effects/pregnancy/. 83 Nancy K. Young, Sid Gardner, Cathleen Otero, Kim Dennis, Rosa Chang, Kari Earle, and Sharon Amatetti, Substance-Exposed Infants: State Responses to the Proble,. HHS Pub. No. (SMA) 09-4369, (Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009), http://www.ncsacw.samhsa.gov/files/Substance-Exposed-Infants.pdf. 84 Mary Velasquez, "Preventing Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders," (address, Texas Infant Health Alliance, Any Baby Can, Austin, May 22, 2009). 85 "Fetal Alcohol Spectrum Disorders: Preventing Alcohol Use During Pregnancy," Centers for Disease Control and Prevention, http://www.cdc.gov/ncbddd/fasd/research-preventing.html. 86 K. Ingersoll, L. Floyd, M. Sobell, and M.M. Velasquez, Project CHOICES Intervention Research Group, "Reducing the Risk of Alcohol-Exposed Pregnancies: A Study of a Motivational Intervention in Community Settings," Pediatrics, 111, no. 5 Part 2, May 2003, 1131-5, http://www.ncbi.nlm.nih.gov/pubmed/12728125?dopt=Abstract. 87 "Fetal Alcohol Spectrum Disorders: Preventing Alcohol Use During Pregnancy," Centers for Disease Control and Prevention, http://www.cdc.gov/ncbddd/fasd/research-preventing.html. 88 "Results from the 2008 National Survey on Drug Use and Health: National Findings," U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, http://www.oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.cfm#3.1.3. 89 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, Center for Public Policy Priorities, www.cppp.org/factbook08. 90 J. Roth, J. Hendrickson, M. Schilling, and D.W. Stowell, "The Risk of Teen Mothers Having Low Weight Babies: Implications of Recent Medical Research for School Health Personnel," Journal of School Health, 68, no.7, September 1998, 271-276, http://www.ncbi.nlm.nih.gov/pubmed/9779401. 91 David Wiley and Kelly Wilson, Just Say 'Don't Know': Sexuality Education in Texas Public Schools," ed. Ryan Valentine, (Texas Freedom Network Education Fund, 2009), http://www.tfn.org/site/PageServer?pagename=JustSayDontKnow. 92 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, Center for Public Policy Priorities, www.cppp.org/factbook08. 93 Centers for Disease Control and Prevention, Youth Risk Behavior Survey 2007, http://www.cdc.gov/HealthyYouth/yrbs/pdf/states/yrbs07_texas_us_comparison.pdf. 94 David Wiley and Kelly Wilson, Just Say 'Don't Know': Sexuality Education in Texas Public Schools," ed. Ryan Valentine, (Texas Freedom Network Education Fund, 2009), http://www.tfn.org/site/PageServer?pagename=JustSayDontKnow. 95 "Prevention of HIV/AIDS, Other STIs and Pregnancy: Group-based Comprehensive Risk Reduction Interventions for Adolescents," The Community Guide to Preventive Services, Centers for Disease Control and Prevention, http://www.thecommunityguide.org/hiv/riskreduction.html. 69 "Onset of Sexual Activity Delayed in Tweens by Theory-Based Abstinence-Only Program." Science Daily Feb. 2, 2010, http://www.sciencedaily.com/releases/2010/02/100201171637.htm. 97 Joyce A. Martin, Brady E. Hamilton, Paul D. Sutton, Stephanie J. Ventura, Fay Manacker, Sharon Kirmeyer, and T.J. Matthews, "Births: Final data for 2006," National Vital Statistics Reports, January 2009, 57-64, http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf. 98 Data is from the year 2006. Centers for Disease Control and Prevention. National Center for Health Statistics. VitalStats: Birth Data Files. http://www.cdc.gov/nchs/vitalstats.htm. 99 "Eliminate Disparities in Infant Health," Centers for Disease Control and Prevention Office of Minority Health and Health Disparities, http://www.cdc.gov/omhd/amh/factsheets/infant.htm. 100 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, (Austin: Center for Public Policy Priorities, 2009), www.cppp.org/factbook08. 101 "Why Are Babies Born with Low Birthweight?," March of Dimes, http://www.marchofdimes.com/professionals/14332_1153.asp#head1. 102 Marian F. MacDorman and T.J. Matthews, Behind International Rankings of Infant Mortality: How the United States Compares With Europe, NCHS Data Brief, no 23. (Hyattsville, MD: National Center for Health Statistics, 2009). 103 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, (Austin: Center for Public Policy Priorities, 2009), www.cppp.org/factbook08. 104 Data is from 2006. "Texas Health Data," Center for Health Statistics, Texas Department of State Health Services, http://www.dshs.state.tx.us/chs/default.shtm. 105 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, (Austin: Center for Public Policy Priorities, 2009), www.cppp.org/factbook08. 106 Preterm Birth: Causes, Consequences, and Prevention, Institute of Medicine, 2006. National Academy Press, Washington, D.C. 107 "C-sections: Medical Reasons," March of Dimes, http://www.marchofdimes.com/pnhec/240_1031.asp. 108 Vani R. Bettegowda, et al. "The Relationship Between Caesarian Delivery and Gestational Age Among U.S. Singleton Births," Clinics in Perinatology, 35, June 2008, http://www.perinatology.theclinics.com/article/S0095-5108(08)00017-1/abstract. 109 Brian Castrucci, "The State of Infant Health in Texas," (address, Texas Infant Health Alliance, Any Baby Can, Austin, March 2009). Source of Data: Texas Department of State Health Services Mortality and Natality Files 1996-2005. The most recent year of data available is 2004-2005. 110 "Benefits of breastfeeding," U.S. Department of Health and Human Services, http://www.womenshealth.gov/breastfeeding/benefits/#a. 111 "Benefits of Breastfeeding," Women's Health website, U.S. Department of Health and Human Services. 112 The three illnesses targeted in the cost analysis are otitis media, gastroenteritis, and necrotizing enterocolitis. Jon Weimer, The Economic Benefits of Breastfeeding: A Review and Analysis. USDA, Food and Nutrition Research, Report No. 13, March 2001. 113 "Breastfeeding Among US Children Born 1999-2006, CDC National Immunization Survey," Centers for Disease Control and Prevention, http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm. 114 Barbara Wilson-Clay, "Breastfeeding," (address, Texas Infant Health Alliance, Any Baby Can, Austin, October 21, 2009). 115 Bridget McCauley, "Breastfeeding," (address, Texas Infant Health Alliance, Any Baby Can, Austin, October 21, 2009). 116 Barbara Wilson-Clay, "Breastfeeding," (address, Texas Infant Health Alliance, Any Baby Can, Austin, October 21, 2009). 117 Kim Updegrove, Mother's Milk Bank of Austin, telephone interview by author, September 7, 2010. 118 "WIC Nutrition: Texas Ten Step Program," Texas Department of State Health Services Website, http://www.dshs.state.tx.us/wichd/lactate/TXfact.shtm#item3. 119 "WIC Nutrition: Texas Breastfeeding Promotion Activities," Texas Department of State Health Services, http://www.dshs.state.tx.us/wichd/lactate/TX10_final.shtm. 120 "Eliminate Disparities in Infant Health," Centers for Disease Control and Prevention Office of Minority Health and Health Disparities, http://www.cdc.gov/omhd/amh/factsheets/infant.htm. 121 Frances Deviney and Florencia Gutierrez, The State of Texas Children: Kids Count Annual Data Book 2008-9, Special Focus: Closing the Educational Gaps, (Austin: Center for Public Policy Priorities, 2009), www.cppp.org/factbook08. 122 Safe Routes to Schools Partnership. "The Relationship Between Physical Activity, Weight, and Academic Achievement." http://www.saferoutespartnership.org/mediacenter/research/231169 123 Hoelscher D.M., Perez A., Lee E.S., Sanders J., Kelder S.H., Day R.S., Ward J. School Physical Activity and Nutrition (SPAN) III Survey, 2004-2005. UT School of Public Health, Houston. 124 Singh, G.K., Kogam, M.D., and vanDyck, P.C. Changes in State-Specific Childhood Obesity and Overweight Prevalence in the United States from 2003 to 2007. Archives of Pediatric and Adolescent Medicine. Vol. 164, No. 7. May 3, 2010. 125 Department of State Health Services, "Texas Overweight and Obesity Statistics," with February 2007 data from the Texas WIC Program: http://www.dshs.state.tx.us/obesity/NPAOPdata.shtm 126 "Findings About the Obesity Epidemic in Texas." Methodist Healthcare Ministries. January 2009. http://www.mhm.org/advocacy/pdf/Keyfindingsobesity12609.pdf. 127 Comments made by Comptroller Susan Combs at Partnership for a Healthy Texas breakfast briefing, "Access to Healthier Foods," Dec. 7, 2010, the Texas State Capitol Building in reference to findings in Gaining Costs, Losing Time: The Obesity Crisis in Texas. Online at: http://www.window.state.tx.us/specialrpt/obesitycost/ 128 Texas Department of Human Services. "The Impact of Diabetes on Aging Texas Well: Costs of Medicaid Long-Term Care Attributable to Diabetes." February, 2002. http://qmweb.dads.state.tx.us/Reports/ltc_diabetes.pdf 129 Belleck, P. "Children's Life Expectancy Being Cut Short by Obesity." The New York Times. March 17, 2005. 130 PolicyLink and The Food Trust, "The Grocery Gap: Who Has Access to Healthy Food and Why it Matters." 2010. http://www.thefoodtrust.org/catalog/download.php?product_id=171 131 The Food Trust website. "Pennsylvania Fresh Food Financing Initiative." http://www.thefoodtrust.org/php/programs/fffi.php 132 Slater, S.J., Ewing, R., Powell, L.M., Chaloupka, F.J., Johnston, L.D., and O'Malley, P.M. "The Association between Community Physical Activity Settings and Youth Physical Activity, Obesity, and Body Mass Index." Journal of Adolescent Health, June 2010. 133 McMillan, T.E. "Research Brief: Walking and Biking to School, Physical Activity and Health Outcomes." Active Living Research. (2009). http://www.activelivingresearch.org/files/ALR_Brief_ActiveTransport.pdf 134 Bike Texas. "Complete Streets." Adapted from the National Complete Streets Coalition. Austin, 2010. 135 National Business Review, "Fast Food Chains Near Schools Lead to Fatter Kids," March 18, 2009. 136 Larson, N. and Story, M. "Are 'Competitive Foods' Sold At School Making Our Children Fat?" Health Affairs, 29(3), March 2010. 137 Cullen, K.W. and Watson, K.B. "The Impact of the Texas Public School Nutrition Policy on Student Food Selection and Sales in Texas." American Journal of Public Health, 99(4), April 2009. 138 American Academy of Pediatrics. "Children, Adolescents, and Television." PEDIATRICS, Vol. 107, No. 2, February 2001. 139 Reuters, "Child Care Doubles TV Time for Some Children," November 23, 2009. http://www.reuters.com/article/idUSTRE5AM4I920091123 140 ScienceDaily. "Preschoolers in Child Care Centers Not Active Enough." December 21, 2009. http://www.sciencedaily.com/releases/2009/12/091218132300.htm 141 Institute of Medicine. "Local Government Actions to Prevent Childhood Obesity." Report Brief. September 2009. http:// www.iom.edu/obesitylocalgov. 142 U.S. Department of Health and Human Services. The Surgeon General's Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010. 143 Texas Education Agency, Division of Health & Safety, "School Health Survey 2009-2010." Questions 17 and 18 asked districts about health education graduation requirements for the school years 2009-2010 and 2010-2011; 197 districts reported not requiring health education in the current school year, but 343 reported that they planned not to have the requirement in the coming school year. A phone call to the Texas Education Agency on June 21, 2010 verified that Texas has 1,235 school districts. 144 Stutz, Terrence. "Study: Physically Fit Texas Students More Likely to Do Well on Achievement Tests."Dallas Morning News, March 10, 2009; Safe Routes to Schools Partnership. "The Relationship Between Physical Activity, Weight, and Academic Achievement." http://www.saferoutespartnership.org/mediacenter/research/231169 145 Brownell et al. "The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages." The New England Journal of Medicine. September 16, 2009. http://www.nejm.org/doi/full/10.1056/NEJMhpr0905723. Accessed August 10, 2010. 146 Henry J. Kaiser Family Foundation, StateHealthFacts.org on Texas Children. http://www.statehealthfacts.org/profileind.jsp?cat=2&sub=14&rgn=45. Accessed September 2010. 147 Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963-1965 Through 2007-2008 by Cynthia Ogden, Ph.D., and Margaret Carroll, M.S.P.H., Division of Health and Nutrition Examination Surveys. http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm . Accessed October 2010. 148 Yale University Rudd Center for Food Policy and Obesity. Study Synposes: Sugar-sweetened beverages and childhood obesity. http://www.yaleruddcenter.org/resources/upload/docs/what/policy/SSBtaxes/SSBStudiesChildhoodObesity8.09.pdf. Accessed August 10, 2010. 149 Abram, Susan, Los Angeles Times. "Soda makes you fat." September 16, 2009, citing data from the UCLA Center for Health Policy Research, which found children are nearly twice as likely and teens about three times as likely as adults in California to drink soda at least once a day. The study also found children's risk of obesity rises 60% with each daily serving of sugary drinks. 150 http://iom.edu/Reports/2009/ChildhoodObesityPreventionLocalGovernments/Action-Steps-Local-Government-Actions-to-Prevent-Childhood-Obesity.aspx. Accessed August 5, 2010. 151 http://usmayors.org/resolutions/76th_conference/chhs_07.asp, Accessed August 6, 2010. 152 http://www.brookings.edu/~/media/Files/rc/reports/2009/0826_btc/0826_btc_fullreport.pdf, Accessed August 6, 2010. 153 http://www.ers.usda.gov/Publications/ERR100/ERR100.pdf. Accessed August 4, 2010. 154 Woodward-Lopez G, Kao J, and Ritchie L. To what extent have sweetened beverages contributed to the obesity epidemic? Public Health Nutrition, Sept 2010. 155 National Public Radio, "Soda in America: Taxes and a Debate over Health." May 4, 2010, http://www.npr.org/templates/story/story.php?storyId=126511372 referencing Fletcher, J.M., Frisvold, D., and Tefft, N. "Taxing Soft Drinks and Reducing Access to Vending Machines to Curb Child Obesity." Health Affairs. May, 2010. http://content.healthaffairs.org/cgi/content/abstract/29/5/1059 156 Apovian CM. Sugar-sweetened soft drinks, obesity, and type 2 diabetes. JAMA. 2004;292(8):978 �C979. http://jama.amaassn.org/cgi/content/full/292/8/978?ijkey=21578c9e864342b94ce540a822e41d05622440e3&keytype2=tf_ipsecsha 157 Dietary and Activity Correlates of Sugar-Sweetened Beverage Consumption Among Adolescents PEDIATRICS Vol. 126 No. 4 October 2010, pp. e754-e761 (doi:10.1542/peds.2010-1229) 158 Miljkovic et al. Economic factors affecting the increase of obesity in the United States: differential response to price. Food Policy 2008. 159 Four sources cited in "Sugar-Sweetened Beverage Taxes and Public Health." Robert Wood Johnson Foundation Policy Brief. 7/2009. 160 Texas Administrative Code. Title 34, Part 1, Chapter 3, Subchapter O, Rule ��3.293. Accessed 10/2009 161 "State sales tax rates for soft drinks and snacks sold through grocery stores and vending machines." Journal of Public Health Policy 29.2 (July 2008): p226(24) http://www.palgravejournals.com/jphp/journal/v29/n2/full/jphp20089a.html. Accessed September 2010. 162 Institute for Health Research Policy at University of Illinois at Chicago, in "A Tobacco-Style Tax on Fattening Drinks," Business Week Online, 1/12/2009. http://www.businessweek.com/bwdaily/dnflash/content/jan2009/db20090111_790778.htm?campaign_id=rss_daily Accessed September 2010. 163 Baxandall, Phineas. "Taxing Habits." Regional Review, 2003. http://www.bos.frb.org/economic/nerr/rr2003/q1/taxhabits.htm. Accessed September 2010. 164 O'Donoghue, Ted, and Matthew Rabin. "Optimal Sin Taxes." Journal of Public Economics. May 2006. 165 Kelly Brownell and Thomas Friedan, "Ounces of Prevention��The Public Policy Case for Taxes on Sugared Beverages." The New England Journal of Medicine. 4/30/2009.(http://www.nejm.org/doi/full/10.1056/NEJMp0902392) 166 Berkeley Media Studies Group. "Sugar Water Gets a Facelift: What Marketing Does for Soda." September, 2009. 167 Brownell et al. "The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages." The New England Journal of Medicine. September 16, 2009. http://www.nejm.org/doi/full/10.1056/NEJMhpr0905723. 168 Marder W and Chang S. Childhood Obesity: Costs, Treatment Patterns, Disparities in Care, and Prevalent Medical Conditions. Thomson Medstat Research Brief, 2006. http://www.medstat.com/pdfs/childhood_obesity.pdf. Accessed August 5, 2010. 169 Trasande L, Liu Y, Fryer G, et al. "Effects of Childhood Obesity On Hospital Care and Costs, 1999�C 2005." Health Affairs, 28(4): w751�C60, 2009 as cited in Robert Woods Johnson Foundation,"F as in Fat, 2010."http://healthyamericans.org/reports/obesity2010/Obesity2010Report.pdf. Accessed August 2010. 170 U.S. Centers for Disease Control and Prevention, "Vital Signs: Adult Obesity" August 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm59e0803a1.htm. Accessed August 2010. 171 Rudd Center for Food Policy and Obesity. " Sugar-Sweetened Beverage Taxes." http://yaleruddcenter.org/what_we_do.aspx?id=271. Accessed September 15, 2010. 172 Kelly Brownell and Thomas Friedan, "Ounces of Prevention��The Public Policy Case for Taxes on Sugared Beverages." The New England Journal of Medicine. 4/30/2009. http://www.nejm.org/doi/full/10.1056/NEJMp0902392. Accessed September 2010. 173 Center for Science in the Public Interest (CSPI). http://www.cspinet.org/liquidcandy/. Accessed October 2010. 174 Phineas Baxandall. "Taxing Habits." Regional Review, 2003. Accessed September 2010. http://www.bos.frb.org/economic/nerr/rr2003/q1/taxhabits.htm 175 Phineas Baxandall. "Taxing Habits." Regional Review, 2003. Accessed September 2010. http://www.bos.frb.org/economic/nerr/rr2003/q1/taxhabits.htm 176 Kelly Brownell and Thomas Friedan, "Ounces of Prevention��The Public Policy Case for Taxes on Sugared Beverages." The New England Journal of Medicine. 4/30/2009, http://www.nejm.org/doi/full/10.1056/NEJMp0902392 177 Email correspondence with The Rudd Center at Yale, August 2010. 178 Center for Science in the Public Interest (CSPI), http://www.cspinet.org/liquidcandy/. Accessed August 5, 2010. 179 First Focus, "Covering Children at the Top of Public Priorities for Health Reform," February, 2010, and First Focus, "Cover all Children from Head to Toe: New Poll Affirms Strong Public Support for Health Reform that Meets the Needs of Children," August 13, 2009. Both are online at: http://firstfocus.net/ Also, Robert Wood Johnson Foundation, "Opinion Poll: 9 in 10 Voters Want SCHIP Reauthorized," August 23, 2007. Online at http://www.rwjf.org/newsroom/product.jsp?id=21931 180 InsureKidsNow.gov, "Children's Health Insurance Program Reauthorization Act: One Year Later Connecting Kids to Coverage," February 4, 2010. Online at: http://www.insurekidsnow.gov/chip/chipra_anniversary_report.pdf 181 U.S. Census, "Health Insurance Coverage Status and Type of Coverage by State and Age for All People: 2008." http://www.census.gov/hhes/www/cpstables/032009/health/h05_000.htm 182 Texas Health and Human Services Commission. 2007. House Bill 15: Frew Expenditure Plan. http://www.hhsc.state.tx.us/medicaid/ExpenditurePlan_0907.pdf 183 Associated Press, "Millions of Medicaid Kids Don't Get Medical Exams," Boston Globe, May 24, 2010. Online at http://www.boston.com/news/local/vermont/articles/2010/05/24/millions_of_medicaid_kids_dont_get_medical_exams/ 184 Annie E. Casey Foundation Kids Count Data Center, "Children 18 and Below without Health Insurance by Age Group." Online at: http://datacenter.kidscount.org/data/acrossstates/Rankings.aspx?ind=33 185 See: Baker Institute of Public Policy at Rice University, "The Economic Impact of Uninsured Children on America," June, 2009. Online at: http://www.bakerinstitute.org/publications/HPF-pub-HoShortUninsuredChildren-060309.pdf. Also The Perryman Group, "Medicaid and the Children's Health Insurance Program (CHIP): An Assessment of Their Impacts on Business Activity and the Consequences of Potential Funding Reductions," April 4, 2003. 186 Families USA, "Paying a Premium: The Added Cost of Care for the Uninsured," June, 2005. Online at: http://www.familiesusa.org/assets/pdfs/Paying_a_Premium_rev_July_13731e.pdf 187 Ray Perryman's 2009 testimony to the Texas Legislature, as quoted by Anne Dunkelberg, Center for Public Policy Priorities, "Proposed Budget Reductions for Current 2010-2011 Beiennium," February 10, 2010 Testimony to a hearing of the Texas Health and Human Services Commission. Online at: http://www.cppp.org/files/6/testimony1011medicaidcuts.pdf 188 Caryn Marks, Cathy Hoffman and Julia Paradise of the Kaiser Commission on Medicaid and the Uninsured, Henry J. Kaiser Family Foundation, "The Impact of Medicaid and SCHIP on Low-Income Children's Health," February, 2009. Online at: http://www.kff.org/medicaid/upload/7645-02.pdf 189 Fairbrother, G.L., Carle, A.C., Cassedy, A., & Newacheck, P.W., "The Impact of Parental Job Loss on Children's Health Coverage," Health Affairs, 29, no. 7 (2010): 1343-1349. 190 Anne Dunkelberg, Center for Public Policy Priorities, "CHIP, Medicaid and Texas Kids." Presentation on January 30, 2009 to the Texas CHIP Coalition, Austin, Texas. 191 U.S. Census, "Number and percent of children under 19 at or below 200% of poverty by health insurance coverage and state: 2008." http://www.census.gov/hhes/www/cpstables/032009/health/h10_000.htm 192 Texas State Auditor John Keel, "An Audit Report on the Supplemental Nutrition Assistance Program at the Health and Human Services Commission," March 26, 2010. http://www.sao.state.tx.us/Reports/report.cfm/report/10-026 193 Celia Hagert, Center for Public Policy Priorities, "Texas's Eligibility System Continues to Fail Needy Texans," September 28, 2009. Online at: http://www.cppp.org/files/3/420_EligibilityR.pdf 194 Donna Ross Cohen, Center on Budget and Policy Priorities, "It Happened One Night," April 6, 2010. Online at the Georgetown University Center for Children and Families website: http://theccfblog.org/2010/04/it-happened-onenight.html 195 Dallas Morning News, "U.S. Fines Texas $4 Million for Botching Food Stamps Claims," June 29, 2010. http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/062810dnmetfoodstamps.ea293fe9.html 196 Marian Wright Edelman, "Expanding the Child Health Safety Net," June, 21, 2010. Online at: http://healthcare.change.org/blog/view/expanding_the_child_health_safety_net 197 Mental Health America, "The New Health Care Reform Law: A Summary of Provisions of Interest to Mental Health Advocates." 198 Texas Medical Association. (2009). Physician and Health Care Professional Workforce Shortage. http://www.texmed.org/Template.aspx?id=6871; The Hogg Foundation for Mental Health. (2008). Health Care in Texas: Critical Workforce Shortages in Mental Health. http://www.hogg.utexas.edu/PDF/Workforce%20Interim%20Senate%20052308.pdf 199 Email correspondence with Helen Kent Davis of the Texas Medical Association. "Provider response to Medicaid cuts." June 18, 2010. 200 Data provided by Research, Strategic Decision Support, Texas Health and Human Services Commission. Sources: AHQP Claims and Enc_Best Picture Universes, TMHP.

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