The Foundation for Child Development’s (FDC), Child Well-Being Index (CWI), tracks how young people in the United States have fared since 1975 via a national, research-based composite measure.  The index combines national data from 28 indicators across seven domains into a single number that reflects overall child well-being.  Based on this information, the Foundation report ranks Colorado 26^th nationally on these child well-being components.

The seven quality-of-life domains considered are: Family Economic Well-Being, Health, Safe/Risky Behavior, Educational Attainment, Community Engagement, Social Relationships, and Emotional/Spiritual Well-Being.

According to the Denver Post, “The study’s key findings are that states with higher income taxes are better for children, and public investments in children, such as education spending, matter a great deal.”   According to the Tax Foundation,” Colorado has dropped 18 places in the state/local tax burden ranking over the last 30 years. It levies every major tax, but the rate on each is among the lowest in the country.” “Spending discipline in the form of Taxpayer Bill of Rights has also helped the state keep tax rates low,” states the Tax Foundation.

In most cases Colorado’s children fared slightly better than the national average.  However, as reported in the The Denver Post, only 86.7 percent of Colorado children had health insurance, compared to a national average of 89.2 percent.  Despite having the seventh worst coverage in the United States in 2007, Colorado’s figures have been improving as more children are enrolled in Medicaid and the Child Health Plan Plus.

Other areas where Colorado’s children face more problems than their peers across the country include Colorado’s suicide rate for children ages 10-19 (6.19 deaths to every 1,000 children) which is nearly twice as high as the national average of 3.97. Colorado also has had a higher incidence of births to mother’s ages 15 to 19 (43.4 births per 1,000) compared with the national rate which stands at 42.5.

CRS applauds the efforts of the Colorado Department of Public Health and Environment to focus its program efforts towards “winnable battles” in areas such as unintended pregnancy, injury prevention and mental health/substance abuse.  Hopefully by focusing on problems such as child health and welfare, where Colorado has a capacity to improve, Colorado’s standing on the Child Well-Being Index will improve in future years.

The Center for Research Strategies would like to congratulate our own, Dr. Paul A. Nutting, along with, Benjamin F. Crabtree, William L. Miller, Kurt  C. Stange, Elizabeth Stewart, and Carlos Jaen, for their published paper: Transforming Physician Practices To Patient-Centered Medical Homes: Lessons From The National Demonstration Project, which, based on online downloads, has made the top ten most read papers published in Health Affairs in 2011.

According to Health Affairs, the paper addresses the role of primary care practices in upcoming health reform discussions and notes “Many commentators view the conversion of small, independent primary care practices into patient-centered medical homes as a vital step in creating a better-performing health care system.”

From June 1, 2006, to May 31, 2008, the authors researched results from the country’s first national medical home demonstration and identified

Dr. Paul A Nutting

some of the difficulties associated with these innovations.  According to the article, “Among other features, the transformation process requires an internal capability for organizational learning and development; changes in the way primary care clinicians think about themselves and their relationships with patients as well as other clinicians on the care team; and awareness on the part of primary care clinicians that they will need to make long-term commitments to change that may require three to five years of external assistance.”

In conclusion, the authors comment that, “Transforming primary care requires synchronizing practice redesign with development of the health care “neighborhood,” which is made up of a broad range of health and health care resources available to patients.” The paper also discusses the requirements for a payment reform system to support practice development and a policy environment to define practical expectations and time frames for the implementation of suitable innovations.

To view Dr. Nutting’s article, visit the Center for Research Strategies website (www.crsllc.org)