Policy & Practice
Child Well-Being Index for 2005
Violence and risky behaviors among children, such as teen birth, smoking, and use of alcohol and illegal drugs, have declined dramatically during the last 30 years, but high obesity rates are problematic, according to the 2005 Index of Child Well-Being released by the Foundation for Child Development. The overall child-health score in 2003 was 17% below 1975 levels, mainly because of obesity. “It took a generation for overweight and obesity to reach these extreme levels, and it's going to take at least a generation to turn those levels back,” said Kenneth Land, Ph.D., developer of the index and a sociologist at Duke University. In the meantime, violent crime has dropped by more than 64% since 1975, and childhood victimization from violent crime has fallen by more than 38%. Those percentages may rise again, however, as “a strong national economy and increased federal funding for community policing are no longer in play,” Dr. Land said. Births to teenage mothers have dropped by nearly 37%. Smoking continues to decline, but the rate of binge drinking increased slightly, from 27.9% in 2003 to 29.2% in 2004, the study found.
Public Mental Health Spending
The percentage of mental health and substance abuse services paid for with public funding is increasing, according to a study by Substance Abuse and Mental Health Services Administration (SAMHSA). Public sources paid for 63% of mental health spending in 2001, up from 57% 10 years earlier. Similarly, the percentage of substance abuse treatment paid for by public sources rose from 62% to 76% over the same period, the study found. Public spending includes Medicaid, Medicare, and spending by all levels of government–federal, state, and local. “Overall, we have seen a decline in inpatient spending and a shift to publicly financed care,” said SAMHSA administrator Charles Curie. “As we continue to work to improve the community-based services available to people in need, it is clear the public sector is now the major financial driver.”
Zyprexa Patent Upheld
A U.S. District Court upheld the patent held by Eli Lilly & Co. on olanzapine (Zyprexa), an antipsychotic drug that accounts for about one-third of Lilly's revenue; net sales in the United States were $2.4 billion in 2004. Two generic drug makers, Ivax Corp. and Teva Pharmaceuticals Industries Ltd. argued that the patent for the drug should never have been issued because Zyprexa was already covered by another patent. Lilly, however, contended that its drug was different from previously patented medications. The judge dismissed all claims against Lilly, noting among other findings that “defendants have failed to prove by clear and convincing evidence that anyone associated with the prosecution of the [Zyprexa] patent misrepresented or concealed … information with an intent to deceive the Patent and Trademark Office.” Ivax officials expressed disappointment with the ruling. “Ivax continues to strongly believe that the Zyprexa patent is invalid and we immediately intend to aggressively pursue all remedies available to us, including appealing this decision to the U.S. Court of Appeals,” the company said in a statement. But Lilly officials hailed the ruling, saying it “sends a clear message on the strength of” the patent.
Preventing Teen Substance Abuse
School-based social skills programs are the best way to reduce substance abuse in adolescents, a Cochrane Review report found. The authors looked at 32 reports and classified the results based on the sorts of interventions used. They found three main types of intervention: increasing students' knowledge of the damaging effects of drugs; building self-esteem to prevent teens from using drugs to feel socially accepted; and peer-based social skills training that included strong role models and equipped people with the skills to “say no” to drugs. “Programs which develop individuals' social skills are the most effective form of school-level intervention in preventing early drug use,” says Fabrizio Faggiano, M.D., professor at the University of Piemonte Orientale, Novara, Italy. “Applying this program at a school level would prevent 1 out of 5 new initiators, which corresponds to a 20% decrease in the prevalence of drug use.”
Uninsured Projections
The plight of the uninsured isn't likely to be resolved anytime soon. More than 1 in 4 American workers under the age of 65 will be uninsured in 2013–nearly 56 million people–driven by the increasing inability to afford health insurance, reports a Health Affairs Web-exclusive article. Because growth in per capita health spending is expected to outpace median personal income by 2.4% every year, health care coverage will continue to decline, because more Americans will find it unaffordable. “It is unlikely that we will be able to solve the problem of the uninsured without some form of universal health insurance requiring contributions from some combination of employers, employees, and taxpayers,” the study said. Children have fared slightly better than adults, mostly because of coverage afforded by the State Children's Health Insurance Program. The researchers estimated that for every 1% increase in the percentage of uninsured adult workers from 1979-2002, there was only a 0.45% increase in the percentage of uninsured children. The researchers based estimates of the uninsured on federal projections of health spending, personal income, and other population characteristics.