Sunday, December 15, 2013

Shocking Rates of Pediatric Asthma in the Tennessee Valley are the Number One Cause of School Absence

Asthma is a chronic medical condition that affects the lungs.  Patients can experience frequent cough, shortness of breath, and chest pain or tightness on a regular basis.  Occasionally a patient with asthma will suffer an “asthma attack.”   During an attack the airways in the lungs become inflamed, make excess mucous, and become constricted.  An asthma attack causes significant trouble breathing and can lead to an emergency room visit, a hospital stay, or even death.  Infections, allergies, and irritants, such as cigarette smoke and pollution, can lead to an asthma attack.  Attacks can easily be prevented with regular doctor visits and effective and inexpensive medications.

7.1 million American children suffer from asthma, which is about 8% of all children, making it one of the most common chronic medical conditions of childhood.  Here in the Chattanooga area, however, 12.5% of our children have asthma, over 50% higher than the national average.  In fact, Chattanooga is the fifth worst city in the country for asthma according to the Asthma and Allergy Foundation of America.  WedMD places Chattanooga second.  These poor rankings are due to low air quality and high cigarette smoke exposure.  Such a staggeringly high rate of asthma in a city conducive to asthma attacks brings the scope of this local problem into focus when considering the following nationwide facts:
·        Asthma is the number one reason children miss school
·        Asthma is third most common reason for a child to spend the night in the hospital
·        Asthma costs our nation 56 billion dollars annually
·        157 children died from asthma in 2009
The most frustrating aspect of these alarming statistics lies in the relative ease in which asthma is treated and attacks are prevented.  Regular doctor visits and readily available medications virtually eliminate symptoms and prevent attacks.  In fact, a recent medical study showed that even 8% of elite athletes from the last five Olympics suffered from asthma.  These athletes have doctors, take their medicine regularly and are able to compete at the highest level of their sport.  Yet, in Chattanooga, one in five children does not have a primary care doctor.  7% of Hamilton County’s children have no insurance at all.  20% of babies in Chattanooga grow up breathing second hand cigarette smoke.  This area has childhood obesity rates 25% higher than national averages.  These factors all play a detrimental role in the lives of Chattanooga’s asthmatic children.

The Pediatric Healthcare Improvement Coalition—Tennessee Valley (PHIC—TV) is a community health partnership striving to decrease the negative impact of asthma on all Tennessee Valley children.  PHIC-TV is currently implementing a strategic initiative to define the asthma challenges for children and organize the means to address themPlease invest in the ongoing work of PHIC-TV and get more information at

Matthew Good, MD, FAAP
Chief of Staff, Children’s Hospital at Erlanger

Pediatric Healthcare Improvement Coalition – Tennessee Valley
P.O. Box 96
Signal Mountain, TN  37377



Monday, December 2, 2013

Untreated Mental Health in Children a Major Driver for School Dropout, Crime and Suicide in Chattanooga

The Pediatric Healthcare Improvement Coalition of the Tennessee Valley (PHIC-TV) has identified Mental Health issues as one of the five major challenges faced by children, adolescents, their families and pediatricians in the greater Chattanooga area. The U.S. Department of Health and Human Services has described mental health as a “state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to change and to cope with adversity.”[i]  The term “mental health” can be broad and often encompasses “behavioral,” “neurodevelopmental,” “psychiatric,” “psychological,” “social-emotional,” and “substance abuse,” as well as adjustment to stressors such as child abuse, neglect, domestic violence, grief and loss.[ii] The genesis of mental health problems stem from biological factors and psychosocial environment as well as interaction between the two.

According to studies cited by the Tennessee Chapter of the American Academy of Pediatrics, “between 9.5% and 14.2% of children birth to age five display social-emotional problems that affect family functioning.” Additionally, “1 in 10 children have a diagnosed behavioral health disorder and more than twice as many children have behavioral health symptoms that cause impairment. Unfortunately, 4 out of 5 of these children do not receive the services they need to improve their behavioral and emotional health.”

The consequences of this unmet need take many forms. In education, students with serious emotional disturbances fail more classes, miss more days of school, have lower grades, and have a higher dropout rate than other students with disabilities.[iii] Interpersonal and educational issues compound over time leading to higher rates of substance abuse, criminal activity and incarceration, poor preparedness for employment, suicide, and a greater impact on social safety nets. The National Alliance on Mental Health’s Children’s Mental Health Fact Sheet[iv] notes:

·         Approximately 50% of students with a mental disorder age 14 and older drop out of high school; this is the highest dropout rate of any disability group
·         65% of boys and 74% of girls in juvenile detention have at least one mental disorder.
·         Suicide is the third leading cause of death in youth aged 15 – 24.

·         When children with untreated mental disorders become adults, they use more health care services and incur higher health care costs than other adults. Left untreated, childhood disorders are likely to persist and lead to a downward spiral of school failure, limited or non-existent employment opportunities, and poverty in adulthood. No other illnesses harm so many children so seriously.(emphasis added)

Given the large number of children and families impacted in the Tennessee Valley and the profound social and economic ramifications when untreated or undertreated, the Pediatric Health Improvement Coalition (PHIC-TV) believes mental health interventions and systems of care should be at the forefront of pediatric healthcare discussions.  Please support PHIC-TV and get more information at

John Farrimond, MBA
President and CEO
Siskin Children’s Institute

Lois Kohrt, MBA
Administrative Director
Siskin Center for Developmental Pediatrics

[i] U.S. Department of Health and Human Services (2001). Mental Health: Culture, Race, and Ethnicity – A Supplement to Mental Health: A Report of the Surgeon General. Rockville, Maryland.
[ii] Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community. Jane Meschan Foy, James Perrin and for the American Academy of Pediatrics Task Force on Mental Health. Pediatrics 2010;125;S75. DOI: 10.1542/peds.2010-788D
[iii] U.S. Department of Health and Human Services (2001). Mental Health: Culture, Race, and Ethnicity – A Supplement to Mental Health: A Report of the Surgeon General. Rockville, Maryland.

The Chasm in Adolescent Medical Care: Psychiatric Disorders

"More than half of adolescents with psychiatric disorders receive no treatment of any sort, says a new study by E. Jane Costello, a Duke University professor of psychology and epidemiology and associate director of the Duke Center for Child and Family Policy. When treatment does occur, the providers are rarely mental health specialists, says the study, which was based on a survey of more than 10,000 American teenagers."

Read more from November 18, 2013 Duke University Press Release