On Wednesday, Oct. 17, experts from Cook Children’s gathered at the Regional Child Health Summit to look at 2018 data and trends from more than 8,000 parents who participated in a survey. People from Tarrant, Denton, Parker, Johnson, Hood and Wise Counties participated in the latest Community-wide Children’s Health & Assessment Planning Survey (CCHAPS).

The purpose of the summit was to look at key children’s health priorities in the region and discuss potential area for community action to improve children’s health with the experts in the room.

During the course of the day, several important topics were discussed. Here are some of the highlights.

1. Play time with other children

• 82 percent of the children in our region play with other children every other day or every day, but there is a decrease in daily play from 2015 (from 71 percent to 63 percent.

2. School safety

• 92 percent across the region report children are safe at school. This is lower than the national rate (98%) and the state rate (97%).

3. Children and health care.

• Children in our region are more likely to have a primary physician than children statewide or nationally – even our homeless children. Between 85 – 98 percent of children in this region have a primary care doctor; compared to 65 percent statewide and 73 percent nationwide.
• 10 percent of children in our region, were without health care at some time in the last 12 months. That’s lower that the state average (15%), but slightly higher than nationwide (8%)

4. School Days Missed

• Children in our region are more likely to miss school than the state and national rates reflect and they are more likely to miss more days annually than statewide and national rates reflect.
• 65 percent of our children miss between 1 and 6 days of school per year due to illness or health problems.

5. Mental Health Disorders

• The most common mental health disorder among children in the area is sleep problems, followed by self-esteem, overeating or undereating, traumatic events, wetting the bed and negative or obsessive thoughts.

6. Bullying

• The number of children in our region bullied or teased at school decreased in 2018 from 17percent to 13 percent. Still the number of kids impacted is large with an estimated 93,655 children.

7. Abuse and Neglect

• Except for Denton, the rate all of the CCHAPS region counties is higher than the statewide rate for all three years. The Denton County rate of confirmed child abuse and neglect victims is half of the statewide rate (4.3 percent vs. 8.5). The Hood County rate is more than two and a half times the statewide rate (23.2 vs. 8.5) [Source: Texas Department of Family and Protective Services Data Book. (2016).]

To learn more about the CCHAPS survey and findings, click here.

A report released this week by the National Academies of Sciences, Engineering and Medicine calls bullying a “serious public health problem” and says the zero-tolerance policies schools use to automatically suspend students for bullying are ineffective.

Lisa Elliott, Ph.D., a licensed psychologist and clinic manager of Cook Children’s Behavioral Health Clinic in Denton, agrees.

“There are so many reasons why zero-tolerance policies don’t work. It’s primarily lip service to look good, but without back bone or laws to support the effort,” Elliott said. “The policy is clearly not working. We aren’t looking at the issues and not addressing the problems. We aren’t teaching children effective tools to handle bullying or conflict.”

Elliott is simply fed up. She’s seen too many kids come into her office depressed, frightened or even suicidal because they can’t get away from their bully or bullies.

“I think that bullying is worse than ever before because of cyberbullying,” Elliott said. “Kids can’t get a break.”

May parents in Cook Children’s six-county service region agree. According to the 2015 Community-wide Children’s Health Assessment & Planning Survey (CCHAPS), 16 percent of parents said their child has been bullied, compared to 10 percent in 2012.

Elliott says there are four types of bullying: physical, verbal relationship (or social) and cyberbullying. Each form of bullying is harmful alone, however combined they are even more harmful and powerful.

Elliott points to the death of David Molak, a 16-year old San Antonio boy, as an example of the harm that his family believes comes from the constant harassment a child receives in the world of cyber bullying.

“In today’s age, bullies don’t push you into lockers, they don’t tell their victims to meet them behind the school’s dumpster after class, they cower behind user names and fake profiles from miles away constantly berating and abusing good, innocent people,” Cliff Molak, the boy’s brother, said in a Facebook post that went viral.

Since the death of David, the Molak family has been working to get “David’s Law” passed in Texas, which would address the issue of cyberbullying in Texas and hold those charged with harassment on social media to pay at least a $500 fee or spend up to a year in prison. State legislation will vote on the law in 2017.

“We need consequences for the people responsible for this kind of bullying and harassment,” Elliott said. “Right now cyberbullying isn’t defined in the Texas harassment statute. A law like David’s law is about someone getting picked on around the clock. This is about constant bullying, where the kids feel like there’s no escape.”

No child is bully-proof. Elliott offers parents the following talking points when speaking to their child about bullying:

• Even people who say they're your friends can bully you.
• You should confront your friends when they're being hurtful to you or others.
• Retaliating may feel good temporarily, but refusing to stoop to the bully's level will win you more popularity in the long run.
• When you hear a false rumor, just ignore it and be yourself.
• You're most likeable when you respect yourself and others.
• Bullies usually have their own insecurities. Returning meanness with kindness is the best way to break down their defense.

And in the end to let kids know that they may be the best resources to end bullying where they live.

Researchers from Princeton, Rutgers University and Yale University found that kids could greatly reduce the amount of bullying and student conflict just by spreading the message against bullying. The engaged group of influential students in 56 New Jersey middle schools spread the message about the dangers of bullying using messaging platforms such as Instagram, print posters and colorful wristbands. They discussed how to handle conflict in their own way with the peers. The team saw a 30 percent drop in student conflict reports.

“Kids have to be involved and they have to stand up to the bullies,” Elliott said. “The kids are the teachers in the moment. We need to empower our children to be the game changers.”

What's under the microscope now is how mental health played a role in these unsettling crimes. While one involved a documented case of schizophrenia, the other is not so clear but may have been tied to depression or possibly a head injury. Yes, these are extreme examples of issues regarding mental health, but they are also reminders of what could go wrong if mental well-being is left unchecked.

It's long been reported that Texas is lagging when it comes to mental health spending. In fact, the state ranks 49th in the country for such spending per capita. At Cook Children's, The Center for Children's Health is working with local partners to expand awareness and access to mental health resources in one local county that especially needed help.

"We have seen higher rates of diagnosed mental illness, bullying at school, self-esteem issues and experience in trauma in 2015 than we did in 2009," said Courtney Barnard, Coordinator for Regional Outreach Services at Cook Children's. "The CCHAPS data tells us what is happening according to parents, but it does not tell us why it’s happening."

Barnard says it could be that kids are experiencing mental health issues and bullying more often or it could mean that parents are more aware of these problems and know what to look for and ask about. The latest numbers from CCHAPS will be the focus of the Denton County Child Health Summit on May 12, 2016, which will be presented by Cook Children's Center for Children's Health. There will also be discussion about the efforts and impact of the Wellness Alliance for Total Children's Health (WATCH) of Denton County. WATCH is a coalition of public and private organizations, born out of the CCHAPS data. The group offers mental health resources to kids, teens, parents and professionals as well as critical support to service providers.

"Moving the needle on children's health is a long-term process because it requires people and organizations to make changes in knowledge, skills, attitudes, beliefs and behaviors," Barnard said. 

About WATCH
The Wellness Alliance for Total Children’s Health (WATCH) of Denton County is a collaboration of both public and private organizations and individuals who are invested in the total wellness of Denton County’s children. WATCH currently works to increase awareness of and access to mental health services in Denton County. Visit www.watchdenton.org for more information.

Obesity? That's one.

Car accidents? That's a big risk too.

But would you guess the number one issue is asthma?

In Tarrant County, 19.5 percent of children suffer from asthma, according to data gathered in a survey sent to parents by The Center for Children's Health led by Cook Children's. The Community-wide Children's Health Assessment and Planning Survey (CCHAPS) was completed by more than 8,600 parents in Tarrant, Denton, Hood, Wise, Parker and Johnson counties.

"We questioned parents on everything from how often their child is buckled in properly to how many grocery stores in their neighborhood sell fresh fruits and vegetables," said Larry Tubb, senior vice president of the Center for Children’s Health. "The information we are gathering is extremely valuable when it comes to measuring the overall health of children in our region."

Overwhelmingly, parents in Tarrant County (and all of the surveyed counties) reported their children are dealing with asthma. In fact, children in this area ages 6-9 are three times more likely to have asthma than children living in other parts of Texas. While we don't know why the numbers are so high, we do know people with asthma have varying triggers, and what affects one person will not necessarily affect another. Those triggers include, but are not limited to, cigarette smoke, indoor and outdoor mold, pet dander, air pollution, dust mites, cockroaches, pollen, smoke and strong odors.

The second biggest health issue on parents minds is obesity, with 17.8 percent reporting concerns about their child's weight, activity level and access to healthy foods.

Accidental injuries rings in third. In Tarrant County, 11.9 percent of parents reported their children had been injured and required medical care. Those injuries range from car and ATV-related incidents to drowning, bicycle falls and crashes.

The fourth issue on the list is a lack of dental care for children. Parents reported 9.7 percent of children either didn't see a dentist regularly, didn't brush their teeth enough or some even reported their child didn't have their own toothbrush.

Finally, mental illness is the fifth biggest issue concerning parents in Tarrant County. Behavioral and emotional development is on the minds of 8.5 percent of respondents. Many reported their children have suffered sleep problems, self-esteem issues or have tried to harm themselves.

The survey used to gather this data is part of a Cook Children's initiative to improve the health and well-being of every child in our six-county region by 2020. This initiative launched in 2009 with the very first survey of its kind sent to parents. Since then, the surveys have been sent out every three years.

"The information provided by parents in our community is available on-line and being used by a host of organizations, including Cook Children’s, to build programs and services. There isn’t one perfect answer, but, together we are making solid progress in improving the health of the children in our community by putting the child and family at the center of our planning," said Tubb.

About The Center for Children's Health

The Center for Children's Health, led by Cook Children's, is home to the Community-wide Children's Health Assessment & Planning Survey (CCHAPS), Community Health Outreach and Community Health Research. The center's goal is to create aligned collaborations that will allow us to make our North Texas region one of the healthiest places to raise a child.