Laying the Foundation for a Healthy Life
A healthy beginning sets the stage for health and well-being for a person’s entire life. These indicators represent important dimensions of children’s health and well-being from infancy through the teenage years. As a society, we can work together to ensure all our children have the opportunity to thrive and reach their full potential.
Goal Highlights
Increasing Breastfeeding Duration
The multiple health benefits of exclusive breastfeeding for both the infant and mother are well established. Exclusive breastfeeding includes only breast milk, without any additional food or drink, not even water.
Breast milk is a complete food source and provides all the energy and nutrients that an infant needs for the first months of life. Breast milk provides infant’s protection from various infections, reduces the risk of Sudden Infant Death Syndrome, and decreases the likelihood of developing obesity and chronic conditions such as diabetes, allergies, and asthma later in life.
The physical connection of breastfeeding provides psychological benefits to both baby and mother, and also provides multiple health advantages to mothers, reducing the risk of breast and ovarian cancer, diabetes and cardiovascular disease.
Healthy Beginnings Indicators
California’s infant mortality rate is lower than the nation’s and has reached a record low.1
Infant mortality is an important indicator of the overall health and well-being of the population. The infant mortality rate is regarded as a highly sensitive measure of population health because there is an association between the causes of infant mortality and other factors that influence the status of whole populations such as economic development, general living conditions, social well-being, rates of illness, quality and access to medical care, public health practices, and quality of the environment. The infant mortality rate is measured as the number of infant deaths before one year of age for every 1,000 live births in that population. About two-thirds of infant deaths occur before a baby is one month old, and the remaining third between two and 12 months of life.2
Infant mortality is linked to women’s health status with healthier moms having healthier babies. Considering nearly half of pregnancies are unplanned, it is critical for women to get healthy now. Women’s health is multifaceted and includes good nutrition, reducing or quitting smoking, and avoiding excess alcohol use. Optimal health also includes managing stress, strong social support, education, economic stability, and being able to live in healthy neighborhoods for physical activity and community safety. Of course, being able to access high quality health care also matters.
Safe Births. Healthy Mothers and Babies.
Cesarean (C-section) deliveries can be life-saving procedures when medically necessary, but they carry a higher risk of negative outcomes for mothers and babies. Complication rates for women also increase with each C-section delivery. Current trends in maternity care show that many pregnant women undergo procedures such as C-sections, repeat C-sections, and labor inductions that may not be medically necessary.1
The C-section rate among low-risk, first-time mothers (also called Nulliparous, Term, Singleton, Vertex (NTSV) Cesarean Birth Rate), is the proportion of live babies born at or beyond 37.0 weeks gestation to women in their first pregnancy, that are singleton (no twins or beyond) and in the vertex presentation (no breech or transverse positions), via C-section birth. Narrowing variation and lowering the average C-section rate will lead to better quality care, improved health outcomes, and reduced costs.2
Vaccines: defense against infectious diseases1
One of public health’s greatest accomplishments is the development of vaccines. These immunizations help keep children from getting certain dangerous vaccine-preventable diseases. California continues to work to improve the number of children vaccinated with up-to-date coverage for the ages of 19-35 months.
One of the State’s biggest barriers to reaching the Let’s Get Healthy California 80% target by 2022 is false information and fears surrounding the long term effect and dangers of vaccinations. Despite recent challenges including public protests, progress continues to be made through collaboration between parents, childcare providers, medical providers, and other key stakeholders.
Adverse childhood experiences have a lasting, harmful effect on health and wellbeing.1
Adverse Childhood Experiences (ACEs) affect nearly two million children in California across socioeconomic lines, putting them at risk for health, behavioral, and learning problems.2 ACEs are traumatic childhood experiences - which include abuse, neglect, and being exposed to violence, mental illness, divorce, substance abuse, or criminal activity in the home - that often leave people more vulnerable to environments and behaviors that can lead to poor health. The more ACEs an individual has experienced, the higher their risk climbs.3
The National Survey of Children’s Health (NSCH) tracks the percent of California children who have experienced ACEs. It uses a set of questions on family, economic, and community adversity to ask parents about current adverse experiences to which their children have been exposed. This population-based survey measures adversity among California children by asking parents about the trauma their children have experienced while they are still children, compared to methods that ask adults to recall their childhood experiences, such as adult retrospective data from the California Behavioral Risk Factor Surveillance System (BRFSS).2,4
Preventing child maltreatment is a public health goal1
Child Maltreatment shows the number of substantiated allegations of child maltreatment per 1,000 children by ethnicity. Neglect, physical abuse, custodial interference and sexual abuse are types of child maltreatment that can lead to poor physical and mental health well into adulthood. The long term negative effects of maltreatment include poor developmental outcomes for children such as increased risk for anxiety, depression, and aggressive behavior.2 Child maltreatment has been linked to higher levels of child and adolescent obesity and sexual risk-taking as well as poor school performance.1 Child maltreatment affects children’s health now and later, and costs our country as much as other high profile public health problems.2
Early learning sets the foundation for success1
Studies have proven that reading skill is linked to health outcomes. Education is associated with longer life expectancy, as well as improved health quality of life and health promoting behaviors.2
Students with limited reading abilities have a harder time keeping up across multiple subjects (including math, science, and other languages), and those who fall behind in the early grades often stay behind. Thus, early intervention is critical for children who are struggling with reading.1
Early learning is a priority for improving health. Increasing the number of 3rd graders who read at or about the proficient level will help set the foundation for success.
Asthma is the most common childhood health condition1
Nearly 1.5 million children in California have asthma and the condition makes it difficult for this group to exercise, play, and attend school.1
There is evidence that children unable to manage their asthma tend to visit emergency departments (ED) at increased rates. Better management of this chronic disease is critical to reducing ED visits and improving the quality of life for children with asthma.
Are California kids physically fit?
Childhood fitness is measured by the percentage of physically fit children, who score 6 of 6 on the required California school FITNESSGRAM® test. The six-part test is used to evaluate levels of fitness that offer protection from diseases related to inactivity. For children, it is important to develop an active lifestyle in the early years of life, since habits from early childhood through adolescence may influence habits in adulthood.1
Over 70 percent of California adolescents are not eating enough fruits and vegetables1
Eating vegetables and fruits is connected with a reduced risk of many chronic diseases, may be protective against certain types of cancer, and may help teens achieve and maintain a healthy weight.2
Learn More » about Healthy Diet – Adolescent Fruit and Vegetable Consumption
Sugar-sweetened beverages are the largest source of added sugar to our diets1
Adolescent sugar-sweetened beverage consumption is measured by the number of adolescents who drank two or more glasses of soda or other sugar drink the previous day. Compared with other age groups, adolescents consume more sugar-sweetened beverages. The added sugar in our diets from these beverages is associated with increased rates of obesity and other chronic health conditions.1
Consumption of sugar-sweetened beverages increases from young childhood through adolescence with the proportion drinking two or more sugar-sweetened beverages daily starting at 4.4% in early childhood (2-5 year olds) and increasing to 20-30% in adolescents (12 to 17 years old).2
Learn More » about Healthy Diets – Adolescent Sugar-Sweetened Beverage Consumption
Obese youth are at greater risk for health problems, including type 2 diabetes, high blood pressure, asthma, early maturation, and joint problems.1
Obese youth are likely to be obese in adulthood. Recently, several chronic diseases which had originally been considered “adult onset” are now appearing at younger ages, including type 2 diabetes and elevated blood pressure.2 This indicator measures the proportion of public school students scoring "Needs Improvement" (Overweight) or "Needs Improvement - High Risk" (Obese) on the Body Composition composite measure of the required California school FITNESSGRAM® test.
Three out of four teenage smokers end up smoking into adulthood.1
Youth are more sensitive to nicotine and can become dependent sooner than adults.1 Nicotine addiction causes about three out of four teenage smokers to end up smoking into adulthood, even if they intend to quit after a few years.1 The indicator for adolescent tobacco use measures the proportion of adolescents who smoked cigarettes in the past 30 days prior to the survey.
Smoking impacts many chronic diseases, such as heart disease, diabetes and asthma.1
We have met the target for this indicator. However, this dramatic drop might be driven by the popularity of emerging tobacco products, such as electronic cigarettes, among youth in recent years. In 2015-2016, 8.6% of high school students in California have used electronic cigarettes in the past 30 days and 13.5% of high school students have used any type of tobacco products (cigarettes, little cigars or cigarillos, kreteks, big cigars, hookah, smokeless tobacco, electronic cigarettes) in the past 30 days.
Emotional and mental well-being are integral to overall health
Physical health and mental health are closely related. This indicator measures the percent of students in 7th, 9th, and 11th grade that have constant feelings of sadness or hopelessness, with the aim of reducing their frequency. Supporting positive mental health for young people is one critical element preparing them for healthy lives.2
Learn More » about Decreasing Frequency of Sad or Hopeless Feelings in Youth
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