PolicyLab

The other week we posted several recommendations for Governor Tom Wolf from PolicyLab faculty and staff to improve the health of Pennsylvania children and families.  This week we have three more recommendations.  These recommendations build on both our clinical experiences with children and families and our research.

We understand these recommendations come at a time of fiscal uncertainty and that tough choices will have to be made.  We believe that many of these recommendations, and those from our earlier blog, could in fact result in savings over time.

1. Strengthen vaccine policies and immunization activities across the state.

The recent measles outbreak that can be traced back to Disneyland has once again brought the importance of vaccines front and center (see here for a recent New York Times article where PolicyLab’s Kristen Feemster is quoted).  Over 100 people from 14 states were reported to have measles in January, most of them stemming from the Disneyland outbreak. While Pennsylvania saw only one case of measles in January, it is still very much at risk for additional measles cases.

According to the National Immunization Survey, Pennsylvania’s rates for some routinely recommended vaccines required for kindergartners, like the measles, mumps, and rubella (MMR) vaccine, are lower (see Table 1) than most other states. Nearly 2% of kindergartners receive a nonmedical exemption to school immunization requirements (compared to only 1% roughly a decade ago).  In this time of rising hesitancy around vaccination, attention to the state’s immunization policies is crucial. 

Additionally, while Pennsylvania has a state immunization registry, participation is voluntary which decreases the reliability of registry data.  For effective surveillance purposes and immunization program planning, we recommend the state support a strong immunization registry.

There are other state policies that could be enacted to help improve immunization rates, especially among adolescents and adults.  For example, legislation was introduced in Pennsylvania during the 2013-14 legislative session to allow pharmacies to vaccinate individuals ages 7 and older (with parental consent).  This could be an important strategy for improving HPV vaccination rates (this vaccination is usually given in a series of three over the course of several months).  It is recommended the administration support the passing of similar legislation this legislative session.

2. Establish a plan for monitoring the implementation of the new child abuse laws.

Changes to the Pennsylvania child abuse laws recently went into effect.  Given the significance of these changes, it is recommended that the Commonwealth track the implementation of the new regulations and reporting requirements across the state.  With an effective monitoring system in place, the administration can ensure the laws are working as intended and tweak them, if need be.

3. Develop a statewide cross-agency data sharing protocol and a strategic plan for data sharing.

Pennsylvania needs a statewide data sharing protocol and a strategic plan for data sharing.  A good example of a state that has developed a successful data sharing protocol with a similar county-level governance structure to ours is Colorado; they achieved this via legislation and limited additional funding.  With a data sharing protocol and plan in place, researchers like us at PolicyLab could do more sophisticated analyses, for example, using our state data on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Early Head Start data to analyze how Early Head Start impacts childhood obesity.  Moreover, a data sharing protocol could make research easier for our state’s great institutions, which might lead to a deeper understanding of data and evidence-based interventions and, ultimately, improved public health outcomes.  Related, other states have a separate office that is tasked with processing research requests and developing data agreements so that the process itself is not a barrier to doing research.  We strongly encourage the Governor to address these important issues.