From the Executive Director

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=118 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="1370e801egerdp.gif"> <div> <FONT SIZE="2" COLOR="#000066" FACE="GeoSlab703 Lt BT" ><A HREF="index.htm" TARGET="_top" TITLE="_"><U><B>HOME</B></U></A></FONT><FONT SIZE="2" COLOR="#000066" FACE="Garamond" ><B> </B></FONT><FONT SIZE="1" COLOR="#000066" FACE="Garamond" ><B>   </B></FONT><B>C</B><FONT SIZE="4" COLOR="#000066" FACE="Garamond" ><B>HILD</B></FONT><B> H</B><FONT SIZE="4" COLOR="#000066" FACE="Garamond" ><B>EALTH</B></FONT><B> S</B><FONT SIZE="4" COLOR="#000066" FACE="Garamond" ><B>ERVICES</B></FONT></div> <div> <B>    </B><B>From the Executive Director</B><B>   |   </B><A HREF="id17.htm" TARGET="_top" TITLE="Mission Statement"><U><B>Mission Statement</B></U></A><B>   |   </B><A HREF="id41.htm" TARGET="_top" TITLE="Board of Directors"><U><B>Board of Directors</B></U></A><B>   |   </B><A HREF="id26.htm" TARGET="_top" TITLE="Main Program"><U><B>Main Program</B></U></A><B>   |   </B><A HREF="id33.htm" TARGET="_top" TITLE="Ways to Give "><U><B>Ways to Give </B></U></A><B>   |   </B><A HREF="id42.htm" TARGET="_top" TITLE="Upcoming Events"><U><B>Upcoming Events</B></U></A><B>   |   </B><A HREF="id19.htm" TARGET="_top" TITLE="Directions"><U><B>Directions</B></U></A><B>   |   </B><A HREF="id57.htm" TARGET="_top" TITLE="Notice of Privacy Practices"><U><B>Notice of Privacy Practices</B></U></A><B>   |   </B><A HREF="selma.htm" TARGET="_top" TITLE="Selma Tribute"><U><B>Selma Tribute</B></U></A></div> <div> <B>              </B></div> </td> </tr><tr> <td valign="top" width=168 BGCOLOR="#C0DCC0" TEXT="#080000"> <div> <I>"Our pediatricians, nurse practitioners, nurses, social workers and nutritionists work as a team to try and ensure that every child is functioning to his or her full potential and that families are able to access other support services they need."</I></div> <DIV ALIGN="LEFT"></DIV> <div> <A HREF="id58.htm" TARGET="_top" TITLE="Main Program"><U>Main Program</U></A></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="Teen Health Clinic"><U>Teen Health Clinic</U></A></div> <div> <A HREF="id23.htm" TARGET="_top" TITLE="Child Development Clinic"><U>Child Development Clinic</U></A></div> <div> <A HREF="id24.htm" TARGET="_top" TITLE="Media Literacy "><U>Media Literacy </U></A></div> <div> <A HREF="id33.htm" TARGET="_top" TITLE="Ways to Give "><U>Ways To Give</U></A></div> </td> <td valign="top" height=362 BGCOLOR="#FFFFFF" TEXT="#080000"> <bR> <div> <B>From the Executive Director:</B></div> <bR> <div> C<FONT SIZE="3" COLOR="#000066" FACE="Geometr231 BT" >hild Health Services provides health care, social services, and nutrition consultation to over 2,000 children and adolescents each year.  To maintain this target enrollment, we have established certain criteria that our client families should meet.  One of these is annual income; family income must be below 185% of the federal poverty level to be enrolled with Child Health Services.  For a family of four this means an annual income of less than $33,543.  But why do we use income as enrollment criteria?  The answer to this may seem obvious---poor children often have difficulty accessing our health care system, but family income can have other subtle and substantial effects on child and adolescent well being.</FONT></div> <bR> <div> Children and families living in poverty face barriers to our health care system.  The obvious one is health insurance.  Poor children are significantly less likely to have insurance or access to a primary care provider than non-poor children.  But there are several less obvious barriers to care faced by low-income families.  Many of the families enrolled at Child Health Services have no method of transportation.  A growing number of families in Manchester face language barriers.  And many families we serve struggle to balance work, daycare, school and other obligations that can make a visit to the pediatrician very difficult.  Factors like these contribute to significantly lower usage of the health care system by poor families and an increased reliance on emergency departments for primary care.</div> <bR> <div> Family income is also a strong predictor of health, development and other outcome measures.  Children living in poverty are almost four times as likely to suffer from lead poisoning and two times as likely to be hospitalized as other children.  Reported cases of child abuse and neglect are over six times as prevalent in poor versus non-poor families.  Children from low-income families are also more than twice as likely to drop out of school than their classmates.  These are some of the outcomes we are trying to affect at Child Health Services.  Our pediatricians, nurse practitioners, nurses, social workers and nutritionists work as a team to try and ensure that every child is functioning to his or her full potential and that families are able to access other support services they need.</div> <bR> <div> Over 12 million children live below the poverty line in the United States.  Here in Manchester, greater than 30% of children live below the poverty line in some census tracts.  Our health care system, and both private and public payers, should recognize the special needs of children living in poverty.  If we are truly going to “leave no child behind” then we must be willing to devote funding and other resources to bridge the gaps that come with a life of poverty.  At Child Health Services we often refer to ourselves as “specialists” in poverty.  But this is a specialty that can only succeed as part of a larger community effort to achieve health and well being for all children.</div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <I>Rob Nordgren, MD, MPH</I></div> <div> <I>Executive Director, Child Health Services</I></div> </td> </tr></table></body>