Galveston Children's Report Card
2003
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Galveston Children's Report Card 2003
This report has been prepared with assistance from

Galveston County Health District;

Galveston Independent School District;

Galveston Partnership for Better Living;

Galveston County League of Women Voters;

University of Texas Medical Branch

Department of Preventive Medicine and Community Health,

Office of University Advancement, Office of Biostatistics,

Office of University Advancement, and

Office of Community Outreach;

Children, Youth and Families: 2010;

and many others.

The cover photograph was provided by Marilyn Brodwick.

Data have been assembled from multiple sources including the

Galveston County Health District,

Galveston Independent School District,

Rosenberg Library,

Texas Department of Health,

Texas Department of Protective and Regulatory Services,

Texas Department of Public Safety, Texas Education Agency,

Texas Workforce Commission, Environmental Protection Agency,

U.S. Bureau of Labor Statistics,

U.S. Bureau of the Census,

U.S. Centers for Disease Control and Prevention, and

U.S. Department of Health and Human Services.

Printed by the Galveston County Health District, October 2003
Website: http://www.gchd.org

Galveston Children's Report Card 2003
Table of Contents

INTRODUCTION

This sixth annual Report Card continues our efforts to monitor the condition of children in the City of Galveston. Maintaining a baseline against which to grade ourselves in the future, the report card provides a roadmap for professional caregivers, volunteers, parents, and citizens concerned about our children.

In Galveston Children's Report Card 2003, we present an overview of the health and quality of life of Galveston's children. This updated report brings together more than 40 key indicators of our children's education, safety, economic security, health, and behavior.

A new set of comparisons for the Report Card are across neighborhoods of the city. The city government, including the City of Galveston Council, has established 11 neighborhoods for the Community Block Grant program. To these we added 3 neighborhoods so as to include the whole island. Last year we added to the Report Card comparisons with League City and Texas City for some indicators. These help us understand our children in the broader context of the county. We added these comparisons because both cities have populations of more than 40,000, which should yield indicators with statistical stability similar to that of the City of Galveston.

We continue reporting summaries of goals and objectives for the education, health, and safety of our children. The Galveston Independent School District (GISD) established the education goal and objectives in its 2000-2001 District Improvement Plan. The U.S. Department of Health and Human Services set forth national goals and objectives for health-related and behavioral indicators in Healthy People 2010. These objectives provide many specific benchmarks against which to assess our progress. In the text, goals are shown in boxes, and objectives are set in italics.

This Report Card assigns letter grades based on percent attainment of stated objectives. Grades for education and health, risky or violent behavior, and substance use are determined as follows: 90% or above is an A, 80%-89% is a B, 70%-79% is a C, 60%-69% is a D, and less than 60% is an F. The 2002 Report Card assigned grades for risky or violent behavior, and substance use. These have not been repeated since no new data are available. In addition, we append a list of goals and objectives stated by Healthy People 2010 for which no local data are being collected currently. When no stated objectives are known, comparisons over time or among the City of Galveston, Galveston County, Texas, and the United States are shown.

For purposes of comparison, most indicators are presented for Galveston's three principal ethnic groups: non-Hispanic blacks, Hispanics, and all others (primarily non-Hispanic whites, plus relatively small numbers of Asians, Native Americans, and multiple race codes). The census data are divided into, black alone, Hispanic-any race, non-Hispanic white, and other. While black alone may include some Hispanics these are thought to be few in number for Galveston. Therefore, the category "Other" for census data is constructed by subtracting black alone, Hispanic any race, and non-Hispanic white from the total. For other indicators, "all others" is sometimes subdivided.

We have organized the report into the following five areas:
1. Population and Family Characteristics
2. Education
3. Safety and Economic Security
4. Health
5. Behavior and Social Indicators

Our report card identifies strengths and achievements as well as weaknesses and areas that require improvement. Underlying the project is our firm conviction that when the Galveston community decides to accomplish a goal, it can.

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METHODS

The indicators used are limited to public data that are readily available. Freedom of Information laws govern their use. These were gathered largely from the Internet or by special tabulations from the Texas Department of Health, the Galveston Independent School District (GISD), and the Galveston County Health District.
The 2002 Report Card contained a great deal of data on adolescent behavior and attitudes. These data are summarized, but the tables are not included. Available data from Census 2000 are reported for many indicators, some of which such as disability have not been reported previously.

A new set of comparisons is across neighborhoods is shown. The city government, including City Council, has specified 11 neighborhoods for the Community Block Grant program. We designated 3 additional neighborhoods so as to include the whole island. The original 11 neighborhoods did not match exactly with the tracts or block groups specified for either the 1990 census or 2000 census. To use census data for neighborhoods, we had to modify slightly the city's boundaries of the neighborhoods resulting in a minimal reallocation of populations. Another difficulty is that tract level data cut across the Old Central and Central Business District neighborhoods. As a result, for most maps and tables, these two have been combined. This will be referred to as the Central-Strand neighborhood. The neighborhood boundaries are shown in Map 1 and Table A.

Map 1. Galveston's Neighborhoods with Census 2000 Block Group Boundaries and Population

Link to Map 1.

Table A. Galveston Neighborhoods used in Report Cards

The definition of adequate immunization has been changed by the Centers for Disease Control and Prevention. In the old definition (4-3-1) means 4 diptheria-pertussis-tetanus (DPT), 3 polia, and 1 measles-mumps-rubella (MMR). The new definition (4-3-1-3-3) adds to 4-3-1, 3 Haemohilis influenza type B (HIB) and 3 hepatitis B.

We have also added a number of new indicators based on the census. However, one, Latchkey Child, needs special attention. If child lives with two parents, and both are in the labor force; or if child lives with one parent, the single parent is in the labor force, we refer to this child as a Latchkey Child. Children may be with other adults or older siblings while the parents work, however this cannot be ascertained from the census.

Many indicators that would be desirable are not included because the data are either unavailable or unreliable because of small sample sizes. Some data may not be collected routinely or may be unavailable because of confidentiality. Although we report rates for mortality and other indicators for which there are small numbers of case, note that rates calculated from small numbers are highly influenced by random fluctuations. As a result, the rates may vary dramatically from year to year. This applies to all rates based on fewer than 25 events.

The reported indicators do not completely define the condition of our city's children, and we have not attempted to explain or offer reasons for what they show. Rather, these indicators represent a broad range of quantitative measures that must be evaluated carefully and placed in context by the personal insights and wisdom of the many groups that work for the benefit of our children.

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RESULTS

Part 1. Population and Family Characteristics (Table 1, Table 2, and Table 3, Map 2)

According to the U.S. Bureau of the Census, the population of the City of Galveston numbered 57,247 on April 1, 2000, and has declined from 59,070 on April 1, 1990. Census 2000 showed that 13,379 Galveston residents were younger than 18 years, and the distribution was nearly equal among the following three ethnic groups: black alone 32.2%, Hispanic 35.5%, and non-Hispanic white 27.9%. The remainder, termed "other," was 4.4% of the under-18 population; most of these children are of Asian origin. The distribution is similar in age groups both for1 to 4 years and 5 to 17 years. Table 1 shows the ethnic distribution for the 903 babies born in 2000: black (30.9%), Hispanic (33.2%), and all others (35.9%).

Galveston's ethnic composition of children differs somewhat from that of League City, where 5.8% are black alone; 16.3% Hispanic; 72.6% non-Hispanic white; and 5.3% other. Texas City's composition is similar to that of Galveston with black alone (30.4%), Hispanic (26.9%), non-Hispanic white (40.4%) and other (2.3%)

The distribution of race varies across neighborhoods. Nearly 1,100 of Galveston's black children live in Carver Park and an additional 1,000 live in either Old Central or Kempner Park. Hispanic children are somewhat more dispersed across the city with 845 in Bayou Shore and 716 in Lasker Park. More than 400 Hispanic children live in each of Carver Park, San Jacinto and Kempner Park. Non-Hispanic white children live primarily in the West End (708), Lake Madeline (592), and Lasker Park (369). The ethnic distribution is shown in Map 2.

Family Characteristics (Table 3, Map 3)

Overall 57.4% of children younger than 6 years live with two parents. This varies dramatically by neighborhood from a low of 32.1% in Carver Park to a high of 75% in the West End. If both parents or the single parent worked, we termed the children "Latchkey," although it is possible that the child stayed at home with an older sibling, other relative, or in a childcare facility. Available data do not permit identifying children without adult supervision. For the city 55.7% of children younger than 6 years of age are latchkey. This varied from a low of 36.8% in San Jacinto to a high of 71.6% in Lake Madeline Map 3.

A similar picture emerged for children ages 5 through 17 years. Overall 52.1% lived with two parents, with a low of 24.8% in Old Central and a high of 69.7% in the West End. Latchkey children were more common in this age range (69.7%) with a low of 57.6% in Carver Park to a high of 77.6% in the West End.

Compared with the rest of the county and Texas, Galveston had the lowest proportion living with both parents, regardless of age. The percentage of latchkey children in the city did not differ appreciably in from those in the rest of the county or the state.

Map 2. Number of children under age 18 by race/ethnic group, neighborhood median household income

Map 3. Percentage 'latchkey children' by age group and neighborhood median household income

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Part 2. Education (Tables 4 through 14)

The Galveston Independent School District (GISD), Galveston Catholic School system, Trinity Episcopal School, Odyssey Academy Charter School, and other small private and religious schools serve the City of Galveston. The District enrolls more than 9,100 students (Table 4). In addition, 112 city residents are enrolled in O'Connell High School (164 total enrollment) (Table 5). Galveston Catholic School had 315 students and Trinity Episcopal School had 276 students in May of 2003. Most of the city's high school graduates received their diplomas from GISD.

The Galveston Independent School District currently enrolls slightly more than 2,500 high school students (attending Ball High School and the alternative school). In 2001, GISD graduated 419 seniors (Table 6). However, for the past 4 years, approximately one third of the high school students in GISD have been in the 9th grade . Thus, although the percentage of 9th graders declined from 41% in 1995-96 to 33% in 2002 (Table B), this distribution remains disproportionate.

Table B. Percent of GISD high school students by class and year

Note: These data are computed from Table 4. Row percentages may not add to 100% because of rounding.

Galveston relies overwhelming on public education for grades 1 through 12 as shown in Table 7. For nursery school, preschool and kindergarten, most students attend public school (72.7%) except in Lindale (21.1%), Central City (37.7%) and Offats Bayou (37.3%). Among grades 1 through 8, more than 80% attend public school, except in the East End (80%) and Lindale (78.3%). Our ratio of public to private school attendance is generally similar to the county and state. League City where only 50.5% of preschool and kindergarteners attend public school, provides a contrast.

The Texas Education Agency (TEA) regulates the calculation of attendance, dropout, completion, and graduation rates (Table 8). These are carefully and specifically defined on the TEA website (http://www.tea.state.tx.us/perfreport/aeis/2002/glossary.html). Attendance rates for GISD have varied between 93% and 94% for the past 6 years. This is slightly below the statewide rate between 95% and 96%. Compared with last year, the annual dropout rates decreased for all three ethnic groups. While the dropout rate for the entire state dropped from 1.3% to 0.9% the GISD dropout rate also decreased from the previous year (from 1.0% to 0.8%) and slightly exceeds that of the state.

The GISD high school completion rate is nearly unchanged at 93.1% in 2001 and is nearly identical to Texas (95.0% in 2002). Our 4-year graduation rates have risen from 53.6% in 1997 to 74.4% in 2001 but are below the Texas rate of 82.8%. Interestingly, these rates are also reflected in the general population, where 74.4% of Galveston residents age 25 and older reported to the Census 2000that they had graduated from high school.

All elementary schools in 2001-2002 had average daily attendance rates of 94.7% or better. The rates for the middle schools exceeded 93% and the rate at Ball High is 92% (Table 9).

The GISD Education Objective [by 2003-04]: In three years, 85% of the students from each ethnic subgroup at each of the grade levels, tested by TAAS, will pass [reading, writing and math] with a score of at least 70% correct.

The Texas Assessment of Academic Skills (TAAS) test results are shown in Table 10. The 2000-2001 GISD Improvement Plan states an objective of an 85% passing rate for all students within 3 years. While non-Hispanic white children have consistently met this objective since 1997 and scores in general have improved in many areas for the other two ethnic groups, improvement is still needed. Hispanic children have steadily improved their passing rates in all tests combined from 42% in 1994 to 81.3% in 2002. However, only 66.7% of Hispanic 8th graders passed, while more than 80% of 4th and 10th grade Hispanic students passed. Unfortunately, black children have not been as successful. A dramatic increase in passing rates for black children has taken place in individual test subjects, but in each grade the passing rates are still far below 85%. Approximately 77.2% of black 10th graders, 59.4% of black 8th graders, and 58.2% of black 4th graders passed all of their TAAS tests.

Beginning in 2003 a new set of tests, the Texas Assessment of Knowledge and Skills or TAKS, were administered. The criteria for passing these tests are still under review. The passing rates are included in the Report Card for information and beginning a new criterion for assessment. Overall the TAKS appears to be a more stringent criterion than the TAAS tests.

Overall GISD's pass rate in 2002 is only slightly below the state pass rate of 85.3%. However, both Texas City ISD (88.3%) and Clear Creek ISD (91.7%) have exceeded the state (Table 11).
Approximately 45% of Galveston's seniors take the SAT/ACT (Table 12). Of these approximately 30% meet or exceed criterion. Approximately 60% of Texas seniors take the test, and only one quarter meet or exceed criterion. Considered together Galveston seniors as a whole are similar to the state in meeting or exceeding criterion.

School performance as rated by the TEA's Accountability Rating System improved significantly from 1997 to 2002 (Table 13). This year 5 elementary schools received accountability ratings of "acceptable" and 3 received ratings of "recognized." One elementary school, Rosenberg, received a "low performing" rating. Austin Middle School and Central Middle School were ranked as "acceptable." Ball High School and Weis Middle School were ranked as "recognized." Overall, GISD is rated as "acceptable."

English as a second language (Table 14) presents a challenge and an opportunity throughout the state and nation. In Texas and GISD more than 4% of children aged 5 to 17 years, are reported by their parents to speak English either "not well" or "not at all." In the county, the percentage is half this. This percentage varies from a low of 0.7% in Lake Madeline to more than 10% in Bayou Shore and Central City.

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Part 3. Safety and Economic Security (Tables 15 through 19)

From 1997 to 2002, the number of completed investigations for abuse and neglect conducted by Galveston County Children's Protective Services (CPS) rose from 1,092 to 1,864 (Table 15). CPS investigation data for individual cities within the county are not available. Confirmed cases of abuse and neglect rose sharply from 319 in 1997 to 545 in 1998, and declined to 481 in 2002. The rate of confirmed victims in Galveston County for 2002 is 9.7 per 1,000 children, which is higher than that of the state (7.9 per 1,000).

Between 1998 and 2002, the number of completed investigations varied from 1,786 to a high of 1,935, but the proportion of investigations with confirmed abuse or neglect declined from 30.5% to 25.8%. While still unacceptably high, the Galveston County percentage is similar to that for Texas, which remains about 25 percent.

The unemployment rate for the City of Galveston rose to 9.5% after a consistent decline from 1996 through 2000 (Table 16). The national unemployment rate rose to 5.8%. Our city's unemployment rate continues to exceed that of the county, the county rate exceeds that of the state, and the Texas rate exceeds that of the United States.

A major effect of high unemployment is children who are economically disadvantaged or living in poverty (Table 17). While nearly 50% of Texas children are economically disadvantaged, 63% of Galveston's children are economically disadvantaged. During 1999, Galveston had 32.3% children classified as living in poverty according to Census 2000. This percentage is markedly higher than the poverty rates for League City (5.1%), Texas City (20.6%), Texas (20.3%), and the United States (16.1%).

Poverty is not evenly distributed across the island but is disproportionately concentrated on the east end of the island (Map 4). Carver Park, Old Central and the East End have rates that exceed 47% for children living in poverty. Nearly 72% of Carver Park children younger than 5 years live in poverty. In other words, nearly half of the island's 1300 children younger than 5 years living in poverty, live in these three neighborhoods. However, every neighborhood has some children in poverty, with the lowest fraction in Lake Madeline (12.9%).

Map 4. Percentage of children living with families in poverty by age and neighborhood median household income

The number of licensed day care facilities in the county has stayed relatively stable over the past 6 years (ranging from 149 in 1997 to 156 in 2002). City data are not available. The capacity of facilities decreased in 2002 (Table 18) to 9,600 places for an estimated 51,540 children. Capacity of registered family homes and 24-hour day care has decreased since 1997; however, this is partially offset by the addition of listed homes beginning in 1999.

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Part 4. Health (Tables 19 through 29)

Healthy People 2010 Goals

Note: Each objective pertains to a specific goal, and one goal may have more than one objective.
Environment and Community (Table 19 and 20)

Healthy People 2010 Objective 8-11: To eliminate elevated blood lead levels in children aged 1-6 years.

Data from blood lead tests reported from 1997 through 2002 indicate a substantially higher percentage of Galveston children tested and found to have elevated levels of lead in their blood than the percentages for all county and Texas children. In 2002 over 16% of tested children in Galveston had elevated levels of blood lead compared with Texas City (3.1%) and Texas (3.2%), and 0 in League City.

In both 2001 and 2002 the county had no days with air quality classified as unhealthful. The city had only 3 or 4 days where the ozone standard was exceeded.

The number of books checked out from Rosenberg Library remains at about 86,000 volumes. Interestingly, the number of audio books, cassettes, and compact discs checked declined to only 1,014. This is a sharp decline from the period 1997 to 2000 when more than 2,300 audio books, cassettes, and compact discs were checked out each year.

The Census 2000 collected information on the presence of mental and physical disabilities (Map 5 and Table 20). In the City of Galveston, approximately 3% of children were reported by parents to have a mental disability and 1% were reported to have a physical disability. These reports are slightly lower than those for Texas and the county. Reports of physical disability ranged from none to 26 children in Lasker Park. Reports of mental disability ranged from 7 children in Lindale to 40 children in Central City.

Live births and adolescent mothers (Table 21 and Table 22)

The number of births and the ethnic distribution of births has remained nearly constant since 1995. The year 2001 saw 905 births to residents of whom 28.4% were black, 36.2% were Hispanic, and 35.4% were all other. This is markedly more uniform than in the county, where 17% are black, 26% are Hispanic and 57% are all other.

Healthy People 2010 Objective 9-07: To reduce pregnancies among adolescent females aged 15-17 to 43 pregnancies per 1,000 (or 4.3%).

City of Galveston data cannot directly address this objective because we do not have data for total pregnancies (including abortions, fetal deaths, and live births). According to the Galveston County Health District, the Galveston County pregnancy rate for women aged 15 through 17 years was 40.4 per 1,000 in 1999 through 2001 combined, and 31.8 per 1,000 for the year 2001 alone.

Births in the city to mothers younger than 18 years dropped from 10.0% in 1994 to 6.2% of all births in 2001. The proportions of births to mothers younger than 18 years for the county and the state were 4.4% and 5.4% respectively, in 2001. Although the city's percentage of births to adolescent mothers remains above those of the county and the state, the trend since 1994 indicates considerable progress over the past several years.

Galveston youth report either having gotten pregnant or having gotten someone pregnant at a rate about three times the national goal (126 per 1000). Approximately 11% of girls report having become pregnant and 14% of boys report having gotten someone pregnant. The rates reported by boys and girls are high for all grades and ethnic groups. The Galveston rates are also much higher than those for Houston (6.3%), Texas (7.4%), and the nation (4.7%).

Healthy People 2010 Objective 9-09: To increase sexual abstinence to 75% of boys and girls (aged 15-17 years)

At the end of 9th grade, only 54% of children report having been abstinent. This declines to 26% at the end of 12th grade. Only 29% of senior girls and 22% of senior boys are abstinent. Overall, for grades 9 through 12, the rates are 47% of girls and 37% of boys. These rates are somewhat lower than those for Houston (50%), Texas (50%), and the nation (54%).

Healthy People 2010 Objective 9-09e: To increase condom use at last intercourse to 49% of unmarried girls (aged 15-17 years)

Healthy People 2010 Objective 9-09f: To increase condom use at last intercourse to 79% of unmarried boys (aged 15-17 years)

In 2002, approximately two thirds of adolescents who have had sexual intercourse reported using a condom the last time they had sexual intercourse. Among girls the percentage was 61.3%, and among boys it was 73.8%; therefore, girls achieved the HP 2010 objective. The rate is highest in 9th grade (77%) and lowest in 12th grade (59.1%), although senior girls also exceed the objective (55.3%). The usage rates for Galveston are higher than those for Houston (65.1%), Texas (55.4%), and the nation (57.9%).

AIDS infection

Healthy People 2010 Objective 13-01: To reduce AIDS among adolescents to 1.0 new case per 100,000.

According to the Galveston County Health District, no new AIDS cases were reported among Galveston County adolescents from 1998 through 2002, and only 5 cases have been reported among county adolescents since 1983. However, two county residents in the group aged 13 through 19 years were reported with HIV infections in 2000, and two more were reported in 2001. No new HIV infections were reported for this age group in 2002.

Mortality (Table 23 and Table 24)

Healthy People 2010 Objective 16-01: To reduce the infant death rate to 4.5 per 1,000 live births.

Forty-six deaths of infants who were city residents from 1997 through 2001 give the City of Galveston an infant mortality rate of 10.0 per 1,000 live births, more than twice that of the target (4.5). The rate for the City of Galveston is also higher than rates for the county (6.4) and for Texas (5.7 to 6.4) over the same period. Table 23 shows detailed data for the city and the county since 1990. Here the births and deaths are assigned to place of residence.

The small number of deaths in each year means that a statistical analysis is required to adjust for random variation. This analysis led to several conclusions about infant mortality rates among children of the city and the county. The most striking is the infant mortality rate among children born to city residents is significantly higher than the rate in the rest of the county.

Moreover, in the balance of the county as in the state and nation, the rates have declined significantly over the 12-year period. We have seen no statistically significant change in the infant mortality rate for residents of the city over the same period. Possibly the city, because of the presence of UTMB, attracts a relatively large number of high-risk infants. In one approach to examine the impact of high risk births at UTMB, all live births under 500 grams were removed from the data set and the analysis was repeated, but again the significant improvement found in the balance of the county was not found among city residents.

The second major finding is that both in the city and the county, blacks have a significantly higher infant mortality rate than all others. Hispanics also have significantly higher infant mortality rates than all others. For the period 1997 to 2001 the rates per 1,000 live births are: 13.2 for blacks, 11.6 for Hispanics , 6.3 for all others.

Healthy People 2010 Objective 16-02: To reduce child deaths aged 1-4 years to 18.6 per 100,000, aged 5-9 years to 12.3 per 100,000, and aged 10-14 years to 16.8 per 100,000, respectively.

From 1997 through 2001, a total of 67 children aged 1 through 14 years died in Galveston County: 19 black, 14 Hispanic, and 34 others. Among these deaths were 12 children of the City of Galveston: 2 black, 5 Hispanic, and 5 others. Fortunately these are too few to draw conclusions; however, the rate for the city is 23 per 100,000 and for the county 24.8 per 100,000.

Healthy People 2010 Objective 16-03: To reduce adolescent deaths aged 15-19 years to 39.8 per 100,000.

Major causes of deaths in this age group include accidents, homicide, and suicide. These three causes alone accounted 55 deaths in the county and 7 in the city during 1997 to 2001 combined. The Galveston County mortality rate was 58.5 per 100,000 for the period. The City of Galveston had a considerably lower rate, 34.7, but this rate is very unstable because of the community's small size. At 58.5 deaths per 100,000, this rate is 47% higher than the target of 39.8. By ethnicity, these deaths of adolescents included 9 blacks, 12 Hispanics, and 34 others.
Prenatal care (Table 25)

Healthy People 2010 Objective 16-06: To increase to 90% the proportion of pregnant women who receive early and adequate prenatal care.

Prenatal care received during the first trimester of pregnancy improves the chances of an infant being born at term with a normal birth weight. The percentage of new mothers in the City of Galveston who received timely prenatal care increased from 82.8% in 1994 to 90.2% in 2001. A lower percentage of black mothers receive early prenatal care compared with the other two ethnic subgroups; the year 2001 percentage of 87.9% for black mothers remains below the Healthy People 2010 goal. The percentages for women in Galveston receiving timely prenatal care exceeds those for the county and the state, and nation.

Low birth weight (Table 26)

Healthy People 2010 Objective 16-10: To reduce the proportion of low birth weight to 5.0% (95.0% of births should be above 5.5 lbs).

From 1994 to 2001, the number of infants born to residents of the city with low birth weights has varied from 83 to 99. The previously reported declines for resident black infants have been wiped out as the rate has risen to 14.4%. Low weight Hispanic births have varied from 4.8% to 7% and all others from 6.5% to 10.4%. Detailed statistical analysis shows no significant change over the 8 years, and further shows that blacks are significantly worse off than Hispanics or all others.

Unfortunately, the proportion of low-birth-weight births to city residents remains higher than those of the county and the state, and the double the objective. Despite our high levels of prenatal care, 10.1% of city residents' newborn infants weighed fewer than 5.5 pounds, compared with the objective of 5%. The county and state percentages (8.2% and 7.6%, respectively) also exceeded the target.

Physical activity reported in 2002 Report Card tables

Healthy People 2010 Objective 22-09: To increase the proportion of adolescents in 9th through 12th grade who participate in daily school physical education to 50%.

In 2002, nearly 54% of Galveston high school students responding to the Youth Risk Behavior Surveillance (YRBS) survey reported being enrolled in physical education (PE) class, which achieves the target level. All ethnic groups have met the goal. The achievement is largely due to the 78.2% enrollment by 9th graders. Unfortunately, it declines to 26.6% in 12th grade. The overall rate is up from the 2000 level of 38.8% and exceeds the overall enrollment percentages for Houston (49.8%), Texas (48%), and the nation (51.7%).

Healthy People 2010 Objective 22-10: To increase the proportion of adolescents in 9th through 12th grade who spend at least 50% of school physical education class time being physically active to 50%.

Among participants in PE classes, 37% exercised at least 20 minutes during class, considerably below the target of 50%. This percentage is also lower than the rate in 2000. The overall rate in Galveston was significantly lower than 76% in Houston and 83% in the United States, which are both also significantly higher than the target.

Watching television reported in 2002 Report Card tables

Healthy People 2010 Objective 22-11: To increase to 75% the proportion of children and adolescents who view two or fewer hours of television per day.

The effects of excessive television watching may be unfavorable to both health and behavior. Of the respondents to the YRBS survey, 49.5% watch television for more than 3 hours per day, virtually the same as in 2000. The rates were 50.7% for Houston, 51.9% for Texas, and 38.3% for the nation. Clearly this is inconsistent with the Healthy People 2010 Objective.
Immunizations (Tables 27 and 28)

Healthy People 2010 Objective 14-22: To achieve and maintain effective vaccination coverage levels for universally recommended vaccines for children aged 19-35 months (90% for each vaccine).

Healthy People 2010 Objective 14-23: To maintain vaccination coverage levels for children in licensed day care facilities and children in kindergarten through the 1st grade (95% for each vaccine).

Beginning in 2001, the Healthy People definition of adequate immunizations was changed from 4-3-1 to 4-3-1-3-3 . This change has resulted in an apparent reduction in coverage. We will use the new definitions this year. For the City of Galveston, the most recent data available on the immunization status of children aged 2 years are for 1999, when the percentage of those children who were adequately immunized was 58.9% for 4-3-1 and 48.6% 4-3-1-3-3. This level of vaccination coverage in the city was lower than that of the county for 4-3-1 (65.0%) and for 4-3-1-3-3 (56.8%) but is higher than the city's percentage in 1994 (47.5%). The target is 90%, and the City of Galveston falls far short of that vaccination level. City of Galveston and county immunization levels at age 2 years appear to be lower than national levels for recent years, which ranged between 73.2% and 80.6%. The national rates are obtained through telephone surveys; while the county rates are obtained by conducting chart reviews. This difference in how data are obtained may account for some of the discrepancy between immunization levels for Galveston County and the nation.

For children aged 5 years, the coverage levels are not as low: the percentage for 4-3-1 immunization in the city improved to 93.7% in 2002 but is at 75.4% for 4-3-1-3-3. The level for the county in 2002 is 91.0% for 4-3-1 and 81.9% for 4-3-1-3-3.

An advantage of the county method of assessment is that it allows evaluation of individual schools. Note that this method reflects not only actual immunization levels but also the quality of record keeping. The data are shown for a sample of schools in Table 28. Only Rosenberg Elementary had significantly lower levels than the other schools in 2001. In 2002, using the new definitions, only Galveston Catholic (88%) was close to the goal. In 2000 Trinity Episcopal School had the lowest reported levels in the city (61.9%).

Sexually transmitted diseases (Table 30)

Healthy People 2010 Objective 25-01: To reduce Chlamydia trachomatis infections among adolescents to 3.0 per 100.

In the City of Galveston, reported cases of infection with Chlamydia trachomatis among adolescents aged 15 through 19 years were high during 1997 and 1998, with 180 and 170 cases, respectively. The number of cases dropped to 132 in 1999 and then rose again to 170 cases in 2000. In 2002 , reported cases totaled 192. This means that at least 4.7% of adolescents in our city had C. trachomatis infections in 2002, nearly two percentage points above the target.

Healthy People 2010 Objective 25-02: To reduce gonorrhea among adolescents to 19 new cases per 100,000.

Although gonorrhea rose dramatically from 43 cases in 1996 to 159 cases in 1998, this disease has maintained a steady 95 cases, since then. However, this still represents an incidence rate of more than 2,200 reported cases per 100,000, which is more than 100 times greater than the national objective. The City of Galveston has higher rates than both the county and state for C. trachomatis and gonorrhea. Both the county and the state have achieved the target level for C. trachomatis but far exceed the target for gonorrhea.

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Part 5. Behavioral and Social Indicators

Seat belt use reported in 2002 Report Card tables

Healthy People 2010 Objective 15-19: To increase use of safety belts to 92% for 9th through 12th grade students.

Approximately 87.5% of Galveston's high school students wear a seat belt when in a car driven by someone else. This represents 95% of the target. The rates of seat belt use are similar in Galveston, Houston, Texas, and the United States. In contrast, 96.3% of Galveston adolescents rarely or never wear a bicycle helmet. This is higher than the percentages for Houston (87.9%), for Texas (92.4%), and for the nation (84.7%).

Youth Violence reported in 2002 Report Card tables

Healthy People 2010 Objective 15-35: To reduce the annual rate of rape or attempted rape to 0.7 per 1,000 adolescents aged 12-19 years.

Galveston boys and girls in grades 9-12 report having been forced to have sexual intercourse (9.6% and 11.5%, respectively). For boys, the rate is higher than rates for Houston (7.5%), Texas (4.8%), and the nation (5.1%). For girls, the rate is similar to those for Houston (10.2%), Texas (11.5%), and the nation (10.3%). All of these rates are many times higher than the national objectives.

Healthy People 2010 Objective 15-37: To reduce physical assaults to 1.4 percent of adolescents aged 12-19 years.

Galveston girls (12.3%) and boys (14.5%) in grades 9 through 12 report having been physically hurt on purpose by their boyfriend or girlfriend. For girls, this rate is higher than rates of Houston (8.5%), Texas (10.8%), and the nation (9.8%). For boys, this rate is also higher than those for Houston (9.5%), Texas (8.7%), and the nation (9.8%). All of these rates are many times higher than the national objective.

Healthy People 2010 Objective 15-38: To reduce physical fighting among adolescents to 32 percent.

Self reported percentages of Galveston girls and boys in grades 9 through 12 having been in a physical fight at least once in the past year were 8.0% and 17.9%, respectively. For both girls and boys, these rates are much lower than those for Houston (33.9%), Texas (32.6%), and the nation (33.2%). Remarkably, physical fighting in Galveston is reported to occur at a rate less than half the national objective.

Not only are our children fighting less, they are at a lower risk of injury from a physical fight in 2002 (3%) than they were in 2000 (5.9%). The current risk of injury is lower in Galveston than in Houston (4.8%), Texas (3.7%), and the nation (4%). This advantage for Galveston applies to both girls and boys.

The risk of injury through other violence remains high, as 18.7% of adolescents in Galveston report having carried a weapon (gun, knife, or club) in the past year. This is slightly higher than the rate for Houston (15.7%), Texas (17.9%), and the nation (17.4%).

Thirty-five juveniles were arrested for violent crimes in 1999, lower than the number in 1996 (164) but higher than the numbers in 1998 (25) and in 1997 (24). The number of arrests increased from 1998 to 1999 among all populations. The number of arrests for the county rose in 1999 to 111. Figures for the state showed a decline in all populations, resulting in an 11% decrease in total arrests for juveniles younger than 18 years during 1999. Juvenile arrest data for 2000 to 2002 have not been submitted by the Galveston Police Department to the Texas Department of Public Safety. Data related directly to the Healthy People 2010 objectives are not available.

Use of alcohol reported in 2002 Report Card tables

Healthy People 2010 Objective 26-06: To reduce to 30% the proportion of adolescents who report that they rode, during the previous 30 days, with a driver who had been drinking alcohol.

During the preceding 30 days, 40.1% of respondents reported riding in a car or other vehicle with someone who had been drinking alcohol. The same rate was reported in 2000. This frequency in Galveston is similar to those for Houston (38.6%) and Texas (39.7%) but higher than that reported for the United States (30.7%).

Not only are our children riding with someone who has drunk alcohol, nearly 20% have driven after drinking in the past month. The same rate was reported in 2000. This is more common in Galveston than in Houston (13.8%), Texas (16.3%), or the nation (13.3%).

Healthy People 2010 Objective 26-09: To increase to 29% the proportion of High School Seniors who have never had an alcoholic beverage (or a target of 71% ever having a drink).

In our city, 76.3% of high school students have had at least one drink of alcohol, which is roughly five percentage points above the target. This is a reduction from the 2000 total of 82.5%. The city percentage is similar to that of Houston (75.2%), Texas (80.7%), and the nation (78.2%).

Healthy People 2010 Objective 26-10: To increase the proportion of adolescents not using alcohol during the past 30 days among adolescents aged 12-17 years to 89% (or reduce to 11% currently using alcohol).

Approximately 50.7% of high school students in Galveston had used alcohol in the month before the survey, an improvement from 54% in 2000. The percentage of Galveston students currently using alcohol is similar to the Texas and national percentages (48.6% and 47.1%) and higher than that for Houston (43.9%). All of these far exceed the target level.

Healthy People 2010 Objective 26-11: To reduce the proportion of adolescents aged 12-17 years engaging in binge drinking of alcoholic beverages during the past 30 days to 2.0%.

Binge drinking is defined as consuming 5 or more alcoholic beverages within a couple hours. Nearly a third of Galveston high school students reported binge drinking in the past month (28.9%). Although this is better than the 32.4% in 2000, binge drinking in Galveston is 14 times greater than the national target. This behavior occurs less often in Houston (25.4%), while the practice in our city is similar to that of Texas and the nation (31.3% and 29.9%).

Illegal use of other substances reported in 2002 Report Card tables.

Healthy People 2010 Objective 26-10b: To reduce the proportion of adolescents aged 12-17 years reporting use of marijuana in the past 30 days to 0.7%.

During the past 30 days, 29.1% of Galveston high school students used marijuana one or more times. Current marijuana use is higher in Galveston than in Houston (20.4%), Texas (21.4%), and the nation (23.9%). Again, however, all four percentages far exceed the objective.

Healthy People 2010 Objective 26-15: To reduce the proportion of adolescents aged 12-17 years who used inhalants in the past year to 0.7%.

Approximately 8% of Galveston's high school students have used inhalants in their lifetimes both in 2000 and 2002. This percentage is similar to that for Houston (8.7%) and lower than those for Texas (13.9%) and the United States (14.7%). Although the YRBS reported "ever using inhalants" and the objective is restricted to use in the past year, we clearly have a considerable distance to go toward achieving the objective.

Use of cigarettes reported in 2002 Report Card tables

Healthy People 2010 Objective 27-02b: To reduce use of cigarettes in the past month among 9th though 12th grade students to 16%.

The initiation of cigarette smoking in Galveston has declined from 62.3% to 55.3% between 2000 and 2002. These rates are lower than those in Houston (62.2%), Texas (66.1%), and the nation (63.9%). In Galveston, 16.2% of youths surveyed reported having smoked at least one cigarette in the past 30 days. Thus we have nearly achieved the goal. Unfortunately this is not true in 12th grade, where 24.8% have smoked at least one cigarette in the past month. The current use of tobacco in our city is lower than the rates in Houston (21.8%), the state (28.4%) and the nation.

Approximately one third of students who smoked cigarettes regularly purchased them in a store or gas station (34.5%). This fraction has declined substantially from 2000, when the rate was nearly 48%. However, access to cigarettes in stores is markedly higher in Galveston than in Houston (25.7%), Texas (18.6%), or the nation (19.1%).

Use of smokeless tobacco and cigars reported in 2002 Report Card tables

Healthy People 2010 Objective 27-02c: To reduce use of spit tobacco in the past month among 9th though 12th grade students to 1%.

Healthy People 2010 Objective 27-02d: To reduce use of cigars in the past month among 9th though 12th grade students to 8%.

Approximately 4.2% of high school students in Galveston report the use of smokeless tobacco. This is more common among young men (7.3%) than among young women (1.5%). The rates are higher in Galveston than in Houston (3.5%) but lower than in Texas (8.8%) and the nation (8.2%). All of these rates are much higher than the Healthy People 2010 objective.

In Galveston, 12.4% of youths surveyed reported having smoked at least one cigar in the past 30 days. This is twice as common among young men (16.7%) as among young women (8.8%). The current use of cigars in our city is similar to that in Houston, Texas, and the nation (12.2%, 15.6%, and 15.2%, respectively). These rates are 50% to 100% higher than the Healthy People 2010 objective.

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HOW ARE WE DOING? TRENDS, COMPARISONS, AND OUR GRADES

The Report Card has been published annually for 6 years. As we stated at the outset, the goal of this report card is to use numerical indicators to identify areas of strength and areas that need improvement. Twenty-five indicators are shown in Table C. The grades are based on the percentage achieved of the previously stated objectives. An A indicates 90% or higher achievement of the objective; an F indicates less than 60%. Table C serves as a report card for Galveston's children.

While the Texas Education Agency rates the Galveston Independent School District as "Acceptable," the district can be proud of its accomplishments. If the goal is 100% completion rates, then the GISD completion rates earn an A. In addition, the 4-year graduation rate has risen consistently for all reporting groups, including the economically disadvantaged. For the Class of 2001, the rate of 77.0% was just below that for the State of Texas (81.1%).

GISD set a goal of an 85% pass rate on the TAAS tests for all groups by 2003-2004. The pass rate has improved in the 8th and 10th grade. We exceeded target and earned As for all ethnic groups in 10th grade. We have also exceeded the target for white students in 4th and 8th grades. For Hispanic students we received a B in 4th grade and a C in 8th grade, both of which represent improvements from 2001. We have improved the scores of black students to an A- in 10th grade and a C in 8th grade. Our mark for blacks in 4th grade has declined to D. The GISD has nearly achieved its objective of an overall rating of "Recognized."

The grades for health are less satisfying. Early prenatal care continues to be better in the City of Galveston than in the county and the state, receiving an A for nearly achieving the Healthy People 2010 objective by 2001. We received a C+ for the immunization of children aged 5 years. The poor performance for immunization of children aged 2 years and the rates of C. trachomatis among teenagers constitute bad news. We have failed our children with respect to gonorrhea infection rates and elevated blood lead levels.

Of particular concern is the unacceptably high level of low birth weight rates and infant deaths among city residents. While both of these rates have declined in the balance of the county, Texas, and the United States, they have remained high in the city. This is true even if the very low weight infants (<500gm) are removed from the analysis.

Four Healthy People 2010 goals and many objectives remain for which no data are available. Surveying children in our schools has proved feasible in the past; to evaluate the goals and objectives will require finding the resources within GISD and the City of Galveston to repeat and extend such surveys.

Having identified areas needing improvement, however, we know that we have the resources to achieve necessary "fixes." The City of Galveston has a tradition of marshalling the forces in the community to meet its goals-goals that are clear and attainable.

Table D. Healthy People 2010 Goals and Objectives for Which No Data Are Available

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LIST OF DETAILED TABLES AND FIGURES

Tables:
1. Births and population of children age and ethnicity and area, 2000
2. Child population by age ethnicity and neighborhood, 2000
3. Age of own children under 18 years in families and subfamilies by living arrangements by employment status of parents, by neighborhood, city, county, and state
4. GISD enrollment, including charter schools, 1995-2002
5. Private school enrollment for the 2002-2003 school year
6. High school graduates, 1996 through 2002
7. Number and percent of population 3 to 17 years enrolled in school by level, by neighborhood, city, county, and state
8. Attendance, dropout, completion and 4-years graduation rates in GISD and Texas, by ethnic group and school year, 1995-96 through 2001-02
9. Attendance rate for all GISD schools, dropout rate for Ball High School, 1995-96 through 2000-01, in percent
10. Students in GISD passing TAAS test by grade level, 1994 though 2002, in percent
11. Students passing TAAS by school district, 2002, in percent
12. College admissions testing, in percent
13. Texas Education Agency rating of GISD schools, 1997 through 2002
14. Number and percent of children reported to speak English "not well" or "not at all": 5 to 17 years of age, by neighborhood, city, county and state
15. Safety: Galveston County Children's Protective Services (CPS) cases
16. Economic security, in percent
17. Children age 0 to 17 in poverty, by neighborhood, city, county and state, 1999
18. Galveston County child care resources
19. Blood lead, air quality, ozone, and library materials: 1997 to 2002
20. Disability for the population 5 to 15 years of age, by neighborhood, city, county, and state
21. Live births, by ethnicity, 1994 through 2001
22. Births to mothers younger than age 18 years, by ethnicity, 1994 through 2001
23a. Infant Mortality by year - Galveston City, Galveston County, and Texas
23b. Childhood mortality: deaths and death rates
24. Births to mothers with late or no prenatal care by ethnicity and year, 1994 through 2001, by place of residence
25. Infants born with low birth weight (less than 5.5 lbs.) by ethnicity, 1994 through 2001, by place of residence
26. Childhood immunization and enrollment in Texas Health Steps, in percent
27. Elementary school children adequately immunized at age 5 years, in percent
28. Children's health insurance and eligibility
29. Reported cases of specified sexually transmitted diseases among adolescents aged 15 through 19 years, by year and place of residence
30. Arrests of juveniles younger than 18 years for homicide, robbery, forcible rape, and aggravated assault
31. Resident children by ethnicity and school attendance area, U.S. Census 2000 and Galveston ISD elementary school enrollment, 2001-02 school year

Figures:

1. Population of the City of Galveston, 2000

2. Children living in poverty, 1989 and 1999

3. GISD students passing all TAAS tests, 1994 through 2001

4. Four year graduation rates: 1997 to 2000

5. Adequate immunization by ages 2 years, ages 5 years and in child care under age 6 years: 1994 through 2001

6. Percentage of births receiving late or no prenatal care, by residence of mother: 1994 through 2001
7. Births to mothers younger than 18 years, by residence: 1994 through 2000
8. Percentage of low-birth-weight infants, by residence: 1994 through 2001
9. Gonorrhea incidence rates: 1996 through 2002
10. Juvenile arrests in the City of Galveston: 1995 through 1999
11. Adolescent weapons carrying, physical fighting and injuries in fights

12. Average monthly unemployment

13. Infant mortality rate per 1000 live births for City of Galveston and balance of the County: Three year running averages