Oregon Option History: Appendix C

APPENDIX C

EVOLUTION OF THE HEALTHY CHILDREN BENCHMARKS

HC1: Increase the percentage of mothers receiving adequate pre-natal care.

1991 Report: While the 1991 report included a benchmarking on prenatal care, it was not among Board's "lead" or "key" benchmarks. The target levels set in 1991 for the percentage of babies whose mothers received adequate prenatal care were 93% in 1990, 98% in 1995, 99% in 2000, and 100% in 2010.(1) Related benchmarks included the percentage of healthy birthweight babies. The historic rates 94% in 1970 and 95% in 1980 were also reported for this benchmark. Target levels were set at 95% in 1990, 96% in 1995, 97% in 2000, and 98% in 2010.(2)

1993 Report: The 1993 Report includes eight benchmarks related to improving access to health care overall. None, however, were explicitly related to improving pre-natal care.(3)

1995 Report: The 1995 Report included a benchmark to track improvement in the percentage of babies whose mothers received adequate prenatal care. However, it was not among the sixteen "urgent" benchmarks.(4) Historic rates of 77% in 1980, 75% in 1989, 76% in 1990, and 79% in 1992 were reported. And targets of 95% in 1995, 2000, and 2010 were set.(5)

Documentation/Data Sources: The percentage is calculated as the number of live births to women who have prenatal visits beginning in the first trimester divided by the total number of live births. Data are published in Oregon Vital Statistics Annual Reports, Oregon Health Division.(6)

HC2: Increase access to safe and affordable child care

1991 Report: While they were not among the Report's "lead" or "key" benchmarks, a series of related benchmarks were included:(7)

improve the ratio of the supply of nonparental child care to the demand for such care;
increase the percentage of nonparental child care capacity whose providers are licensed or registered, listed with a resource and referral agency, or nationally accredited; and
decrease the average percentage of household income spent on child care per year by households below median income.

1993 Report: The 1993 Report included increasing the percentage of child care facilities which meet established basic standards as one of sixteen urgent benchmarks. In 1990, this rate was

20% and it increased to 23% by 1992. Target rates were proposed at 90% in 1995, 100% in 2000, and 100% in 2010.(8) Three related items were also included in the quality of life benchmarks: percentage of related child care facilities that are accredited; number of identified child care slots available for every 100 children under age 13; and percentage of families for whom child care is affordable.(9)

1995 Report: Improving the percentage of child care facilities which meet established basic standards was maintained as a benchmark in 1995, but was not among the sixteen "urgent" benchmarks. Historical data were updated to a 26% in 1990, 30% in 1992, and 36% in 1993. Target rates were unchanged from 1993 Report.(10) There were two related benchmarks including: number of identified child care slots available for every 100 children under 13, and percentage of families for whom child care is affordable.(11)

Documentation\Data Sources: Child care facilities include child care centers, family child care providers, and group child care homes. Standards are set by the Child Care Division of the Oregon Employment Department. Data were drawn from administrative files of the Child Care Division.(12)

HC3: Increase percentage of two-year-olds with complete immunizations

1991 Report: Upping the percentage of babies and toddlers receiving basic health care was among the Report's benchmarks. Neither historic rates nor proposed target levels, however, were provided.(13)

1993 Report: The Report called for efforts to increase the percentage of two-year-olds who are adequately immunized. This rate stood at 47% in 1992, and target levels of 80% in 1995, 100% in 2000, and 100% in 2010 were proposed.(14)

1995 Report: The 1995 Report continued the focus on immunizing two-year-olds. Historic data was updated to show rates of 47% in 1992, 50% in 1993, and 53% in 1994. The target levels remained unchanged from 1993 -- 80% in 1995, 100% in 2000, and 100% in 2010.(15)

Documentation/Data Sources: In the 1995 Report, the Oregon Health Division reported data retrospectively from a survey of all children entering first grade.(16) In the future, data will be provided based on a survey of two-year-olds and data from the state Immunization Registry.

HC4: Reduce rate of HIV infection among childbearing women.

1991 Report: While none of the benchmarks were specifically linked to HIV infection rates, the 1991 Report had a benchmark related to tracking the number of deaths annually attributed to AIDS. The rate in 1990 was 206, and targets are proposed at 1,000 in 1995, 206 in 2000, and 100 in 2010.(17)

1993 Report: Two "urgent" benchmarks related HIV infection rates were included among the 1993 benchmarks. The first tracked the overall number of HIV cases and the second focused on the annual percentage of HIV cases with an early diagnosis.(18)

1995 Report: As in 1993, the 1995 report contained two "urgent" benchmarks to track the annual percentage of HIV cases with an early diagnosis.(19)

Documentation/Data Sources: Data are drawn from the Oregon HIV/AIDS Annual Report provided by the HIV Program, Oregon Health Division.(20)

HC5: Reduce child abuse and neglect.

1991 Report: A benchmark to reduce the number of children abused or neglected per 1,000 children under 18 was first set in 1991. The current rate was reported as 12.3/1,000 as of 1990. Target rates were set at 9 in 1995, 6 in 2000, and 2 in 2010.(21)

1993 Report: While it was not among the "urgent" benchmarks in 1993, the Progress Board maintained a child abuse benchmark. The indicator again tracked the number of children under eighteen who were abused or neglected per 1,000 persons. The rate in 1992 was cited as 10.5/1,000. Target levels were unchanged from the 1991 report.(22)

1995 Report: In 1995, the child abuse benchmark was upgraded to a "core" benchmark. And historic rates were updated as 12.3 in 1989, 11.2 in 1990, 10.5 in 1991, 11.3 in 1992, and 10.8 in 1993. Target levels for future years were unchanged.(23)

Documentation/Data Sources: The benchmark reflects the number of children who are reportedly abused, neglected, and abandoned per 1,000 children. Data are drawn from the Children's Service Division administrative files.(24)

HC6: Reduce teen pregnancy.

1991 Report: Reducing teen pregnancy rates was one of seventeen "lead" benchmarks. The benchmark was based on pregnancy rates per 1,000 females ages 10-17. Historic levels of 24.7 in 1980 and 19.5 in 1990 were reported. And target levels were proposed at 9.8 in 1995, 8 in 2000, and 8 in 2010.(25)

1993 Report: The 1993 Report included teen pregnancy as one of twenty-seven "urgent" benchmarks. Historic data was expanded to report rates of 24.7 in 1980, 19.6 in 1990, and 19.3 in 1992. Target rates for future years were unchanged.(26)

1995 Report: Addressing teen pregnancy remained one of sixteen "urgent" benchmarks. Data on rates in prior years was updated in 1995, however. Rates for prior years were cited as 24.7 in 1980, 19.7 in 1990, and 17.9 in 1992. Target levels were unchanged.(27)

Documentation/Data Sources: The benchmark reflects the number of live births and induced abortions among females age 10-17 divided by an estimate of the number of females age 10-17. Live birth and induced abortion statistics are drawn from Oregon Vital Statistics Annual Reports published by the Oregon Health Division. Population Estimates for Oregon, published by Portland State University, provides the estimate of the total number of females age 10-17.(28)

HC7: Improve early childhood development.

1991 Report: Increasing the percentage of children entering kindergarten meeting specific development standards for their age was one of seventeen "lead" benchmarks in 1991. Neither historic nor target levels were reported.(29)

1993 Report: Early childhood development remained one of twenty-seven "urgent" benchmarks in 1993. Neither historic or target levels were included in the report.(30)

1995 Report: Included once again as one of sixteen "urgent" benchmarks, the Progress Board also provided the first, partial historic data but had not yet set future goals. Historic levels included: as of 1993 88% of children entering kindergarten met language and literacy development standards and 69% met physical well being standards.(31)

Documentation/Data Sources: Benchmark data are drawn from the Oregon Early Childhood Development Assessment.(32)

HC8: Increase percentage of healthy birthweight babies.

1991 Report: While a benchmark for improving the percentage of birthweight babies was included in 1991, it was not among the Report's "key" or "lead" benchmarks. Historic rates were reported as 94% in 1970 and 95% in 1980. Targets were set at 95% in 1990, 96% in 1995, 97% in 2000, and 98% in 2010.(33)

1993 Report: The healthy birthweight babies benchmark was continued in 1993. Historic data was expanded to report rates of 94% in 1970 and 95% in 1980, 1990, and 1992. Target levels were unchanged from 1991.(34)

1995 Report: The 1995 Report included the birthweight indicator among the "Benchmarks for People". And target levels were once again unchanged.(35)

Documentation/Data Sources: The indicator is generated by dividing the number of infants who weight more than 5.5 pounds at birth divided by the total number of live births. The information is drawn from Oregon Vital Statistics Annual Report from the Oregon Health Division.(36)

HC9: Decrease infant mortality rate.

1991 Report: There were no benchmarks related to infant mortality rates included in the 1991 report.

1993 Report: In 1993, a benchmark to track the rate of infant mortality per 1,000 was proposed. Historic rates were cited as 10.8 in 1980, 8.8 in 1990, and 7.2 in 1992. Target levels were set at 7.5 in 1995, 6.0 in 2000, and 4.0 in 2010.(37)

1995 Report: The infant mortality benchmark was included among the "Benchmarks for People" in 1995. Data on historic levels were also updated as 12.1 in 1980, 8.8 in 1990, 8.3 in 1990, 7.2 in 1991, and 7.1 in 1992. Target levels for future years were unchanged.(38)

Documentation/Data Sources: The mortality rate reflects the number of infants who die within one year of birth divided by the number of live births during the same calendar year. These are reported in Oregon Vital Statistics Annual Report from the Oregon Health Division.

APPENDIX C

EVOLUTION OF THE HEALTHY CHILDREN BENCHMARKS

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