Chapter 2. Effectiveness: Maternal and Child Health
Importance and Measures
In 2002, there were over 4 million babies born in the United States with an average life expectancy of 77.4 years1, 2. In 2000, children under age 18 comprised 26% of the U.S. population'72.3 million people3.
Maternal Morbidity and Mortality
- During pregnancy and delivery, women are at risk for high blood pressure, gestational diabetes, and other disorders.
- Maternal mortality (death during delivery or soon afterward) is rare in the United States. In 2001, there were only 399 reported cases of maternal mortality4.
Child Morbidity and Mortality
- Infants (children younger than 1 year of age) had a higher death rate than any other age group under age 55.
- Accidents were the leading cause of death for children and youth ages 1-24; leading causes of death for young people ages 15-24 also included homicide and suicide4.
- In 2001, from 12% to 19.6% of children were identified as having a special health care need'a chronic condition with a functional limitation or other consequence5.
- Among the most highly prevalent chronic conditions of childhood in 2002 were asthma (12% of children), respiratory allergies (12%), learning disabilities (8% of children ages 3-17), and attention-deficit/hyperactivity disorder (7% of children 3 to 17)6.
- Although not in itself a disease, overweight, if unchecked, can lead to other diseases (e.g., diabetes, cardiovascular disease) during childhood and in adulthood. Overweight among children has increased over time. In 2000, 15.3% of children ages 6-11 were overweight, compared to 11% in 1988-947.
Cost
- Children ages 0-17 accounted for about 10% of total national health care expenditures in 2001, or about $73.4 billion.
- Among all children with expenditures, children with special health care needs (CSHCN) account for a disproportionate percentage of health care expenditures8, 9.
Measures
The NHQR tracks several measures related to maternal and child health care throughout the report. This section highlights measures in three areas:
- Maternity care, including prenatal care and obstetric trauma
- Clinical preventive services to prevent overweight in children
- Experiences of care for children with and without special health care needs