New Plan to Target Children's Medical Issues

The District will target some of the worst health problems affecting District youth, from obesity and asthma to infant mortality and teen pregnancy, through a new public-private partnership to be announced today.

The Child Health Action Plan, the culmination of several months of discussions by a multi-agency city commission, sets fairly ambitious targets for reducing the incidence of these diseases and conditions by 2012 or earlier. It wants to cut children's emergency-room visits because of asthma by 10 percent and halve the number of chlamydia infections among adolescents. Annual dental visits should increase by more than a third, according to another goal, so that at least 55 percent of young people receive oral health care.

Officials have attached no price tag to their proposed actions, which they hope to finance through current budgets augmented by federal grants.

Neither the mayor's office nor the city's Health Department would comment yesterday on the plan, a copy of which was obtained by The Washington Post. Its introduction opens with its guiding principle: "Growing up healthy is every child's right." And with stronger city leadership and the collaboration of community providers and organizations, it adds, "we will make dramatic improvements in the lives of children, youth and families."

Although the District has made some strides in recent years -- its school immunization rate, for example, is among the best in the country -- many young people grow up at risk of serious health complications.

"The global health of the children living in the District of Columbia is challenged," said Mark Weissman, chief of general pediatrics and community health at Children's National Medical Center. "We should be able to get our arms around these boys and girls and do a better job of caring for them."

Weissman has not seen the new plan but endorsed its comprehensive approach and measurable outcomes as "essential for making meaningful change."

"It's the only way you're going to move the bar," he said.

Substance abuse is one of the nine areas the action plan addresses. A third of District youth use alcohol and more than one in 10 binge-drinks, surveys show. Thirteen percent smoke.

The city's goal is to decrease those numbers by at least 10 percent. Its plan specifies that two city agencies and Howard University will jointly conduct "50 workshops, five assemblies, 10 conferences and 25 health fairs" this year to educate students, parents and residents about alcohol, tobacco and other drugs. A "prevention blitz" day is to be held this fall to reach several thousand people, in part through the assistance of faith-based groups.

And the problem of overweight children will receive much attention, with a host of city agencies and nonprofit groups identified as responsible for reversing obesity rates by 2010. In some D.C. neighborhoods, surveys suggest, as many as 45 percent of children are obese and in danger of being diagnosed, even in their teens, with diabetes and heart disease.

The new plan tackles nutrition and physical activity. It calls for increased neighborhood access to healthy food choices -- a Health Department study is underway -- and policies to ensure that school meals exceed federal nutrition standards. It proposes expanded fitness programs, especially in low-income communities where children often do not have as many green and safe spaces for play. The plan also looks at the need for insurance coverage for medical treatment related to obesity. City officials already are working to include that in an amended Medicaid plan.

The strategies have the support of Ruth T. Perot, executive director of the Summit Health Institute for Research and Education in the District, which focuses on health disparities and wellness promotion. Obesity has become one of its prime issues in recent years.

"We're very optimistic," Perot said, adding that if the plan successfully brings key people and groups together, "remarkable things can happen."

Still, she will be watching whether the efforts are adequately funded. "If indeed [this] is a priority, then dollars have to follow," she said. "The cities and communities that have done best in promoting child health are those jurisdictions that have put dollars into it."