Thesis (Ph. D.)--Columbia University, 1916. / Vita. Bibliography: p. 93.

Thesis (Ed. D.)--Virginia Polytechnic Institute and State University, 1992. / Vita. Abstract. Includes bibliographical references (leaves 168-171). Also available via the Internet.

Introduction: The following risk factors have found to be associated with inadequate health care and have been found to affect the well-being of children: racial or ethnic minority, poverty status, median family income, family structure of household, maternal education level, and parental employment status. Also, there has found to be health indicators including, teen pregnancy, asthma hospitalization, and lead poisoning cases that affect the well-being of a child and are associated with the presence of these risk factors in a population. Objectives: The objectives of this study is to (1) compare the presence of risk factors and health indicators in Richmond, Virginia to two surrounding counties and with the state of Virginia and (2) to assess the need for a program designed to conduct an annual physical examination program for selected Richmond Public Schools.Methods: The United States Decennial Census data was collected for Richmond City, Chesterfield County, Henrico County, and for the state of Virginia. Also, data on health indicators was collected from Virginia Health Communities and Kids Count Data respectively. Ratios were calculated for the risk factors aforementioned, as well as for health indicators available. Poisson regression was used to determine the cumulative effect of a child have multiple risk factors. Results: There was a significant difference between the four localities in regards to distribution of racial/ethnic minorities, poverty status of children, family structure of households with children, maternal education level, and parental employment status. Richmond was found to have higher ratios for all risk factors tested. In terms of the health indicators analyzed, there was a significant difference between Richmond, Chesterfield, Henrico, and Virginia in regards to teen pregnancy, asthma hospitalization, and lead poisoning cases, with Richmond having the highest prevalence of each of these indicators. Discussion: Because of the prevalence of risk factors in Richmond children for inadequate access to health care, a program was designed to conduct an annual physical examination program for select Richmond Public schools. The initiative would attempt to identify populations within the city at greatest risk and provide a program that would not only provide annual physical examinations, but also provide continual care for children with additional health needs. Conclusions: The use of public school systems for an avenue to provide needed health care for children has been found to be beneficial. The program described to provide annual physical examinations for children in selected Richmond Public Schools, can serve as a template for other communities with similar risk factors.