Press Coverage Rural kids face gaps in health care, schooling, survey finds By Danielle McNamara Sacramento Bee June 20, 2007 Jun. 20--Children in rural reaches of the Sacramento region have less access to quality health care and education than urban counterparts, according to a statewide survey of child health. The disparity is worst in California's rural counties where median incomes are well below the state average, poverty is greater and quality medical and educational facilities are farther from the reach of many families, according to Children Now, an Oakland-based health care research and advocacy group. In Sacramento County, where there is a stronger mix of urban, suburban and rural neighborhoods, children fare about as well as the statewide average in areas such as dental coverage and regular doctor visits. The survey is designed to highlight gaps in health care and educational services, and to put an array of state statistics in one place. The goal, Children Now said, is to elevate childhood health issues as a priority among state and federal legislators. The data come as Gov. Arnold Schwarzenegger pushes a form of universal health care to increase access to basic medical services in California. "We saw those kinds of urban-rural disparities all over the state" said Corey Newhouse, an analyst with Children Now. "La Jolla and Tulare are two completely different places for a child to grow up." Survey results were gleaned from the U.S. Census, the California Department of Education and the California Health Interview Survey. While children in the Sacramento region's rural areas were insured at an average rate, quality care choices are often limited, according to the survey. Ninety-three percent of children in Sacramento County have health insurance, which is also the statewide average. But most cities have health initiatives that provide access to a variety of low-cost services, Newhouse said. Rural residents are often forced to pay out of pocket or to travel for care. "In rural areas, things are spread out, so it is harder to have access to quality care," Newhouse said. "If there are only a few doctors in your town and none of them are accepting new patients, it sometimes takes making long trips to get preventative care." Access may also explain higher teen birth rates in rural counties. Sacramento had 36 teen births per 1,000. The statewide average was 37. The number jumps to 50 in Colusa County, and 61 per thousand in Yuba. In smaller communities, teens may fear their parents will find out about a doctor's visit regarding contraception, said Dr. Glennah Trochet, Sacramento County health officer. "Access to confidential services can be an issue in these areas," she said. "Unfortunately, we in public health know that parental knowledge is a deterrent to teenagers accessing contraception but it doesn't seem to stop them from having sex." In Yolo, Yuba and Sutter counties, women received early prenatal care at lower rates than other parts of the state, according to the results, published as the Children Now 2007 California County Data Book. The book provides statistics for 45 different indicators of child health. The report also addresses education access and achievement. Preschool enrollment in Colusa County is 26 percent, among the lowest in the state. The state average is 42 percent. By comparison, Sacramento County has 35 percent of its children in preschool. Children who attend preschool are thought to be better prepared to succeed in grade school and beyond. The report indicated that educational disparities continue into grade school, with Yolo, Yuba and Colusa county students less likely to score well on the California Standards test in English and math. "People who live in rural areas are under served in many ways," Newhouse said. "This data sheds some light on that."