Twenty scientists and engineers at the 91探花 are among the 38 new members elected to the Washington State Academy of Sciences for 2021, according to a July 15 . New members were chosen for 鈥渢heir outstanding record of scientific and technical achievement, and their willingness to work on behalf of the Academy to bring the best available science to bear on issues within the state of Washington.鈥�

Current academy members selected 29 of the new members. An additional nine were elected by virtue of joining one of the National Academies.

New 91探花members who were elected by current academy members are:

• , professor and Port of Tacoma Chair in Environmental Science at 91探花Tacoma, director of the and science director of the , 鈥渇or foundational work on the environmental fate, behavior and toxicity of PCBs.鈥�
• , professor of psychology, 鈥渇or contributions in research on racial and gender inequality that has influenced practices in education, government, and business鈥� and 鈥渇or shifting the explanation for inequality away from individual deficiencies and examining how societal stereotypes and structures cause inequalities.鈥�
• , professor of chemistry and member faculty at the , 鈥渇or leadership in the innovative synthesis and chemical modification of nanoscale materials for application in light emission and catalysis.鈥�
• , professor of global health and of environmental and occupational health sciences, and founding director of the , 鈥渇or work on the health impacts of climate change, on climate impact forecasting, on adaptation to climate change and on climate policy to protect health.鈥�
• , professor of environmental and forest sciences and dean emeritus of the College of the Environment, 鈥渇or foundational studies of regional paleoenvironmental history and sustained excellence in academic leadership to catalyze and sustain transformative research and educational initiatives.鈥� Graumlich is also president-elect of the American Geophysical Union.
• Dr. , the Joseph W. Eschbach Endowed Chair in Kidney Research and co-director of the , 鈥渇or pioneering contributions and outstanding achievements in the development of the novel wearable artificial kidney, as well as numerous investigator-initiated clinical trials and multi-center collaborative studies.鈥�
• , professor of environmental chemistry and chair of the Physical Sciences Division at 91探花Bothell, 鈥渇or leadership in monitoring and understanding the global transport of atmospheric pollutants from energy production, wildfire, and other sources, as well as science communication and service that has informed citizens and enhanced public policy.鈥�
• , professor and chair of psychology, 鈥渇or contributions demonstrating how psychological science can inform long-standing issues about racial and gender discrimination鈥� and 鈥渇or research that has deep and penetrating implications for the law and societal efforts to remedy social inequities with evidence-based programs and actions.鈥�
• , the Leon C. Johnson Professor of Chemistry, member faculty at the and chair of the Department of Chemistry, 鈥渇or developing new spectroscopy tools for measuring energy flow in molecules and materials with high spatial and temporal resolution.鈥�
• , professor of astronomy, 鈥渇or founding the and leading the decades-long development of the interdisciplinary modeling framework and community needed to establish the science of exoplanet astrobiology鈥� and 鈥渇or training the next generation of interdisciplinary scientists who will search for life beyond Earth.鈥�
• , professor and chair of aeronautics and astronautics, 鈥渇or leadership and significant advances in nonlinear methods for integrated sensing and control in engineered, bioinspired and biological flight systems鈥� and 鈥渇or leadership in cross-disciplinary aerospace workforce development.鈥�
• , associate professor of chemistry and member faculty with the Molecular Engineering and Sciences Institute, 鈥渇or exceptional contributions to the development of synthetic polymers and nanomaterials for self-assembly and advanced manufacturing with application in sustainability, medicine and microelectronics.鈥�
• Dr. , Associate Dean of Medical Technology Innovation in the College of Engineering and the School of Medicine, the Graham and Brenda Siddall Endowed Chair in Cornea Research, and medical director of the 91探花Eye Institute, 鈥渇or developing and providing first class clinical treatment of severe corneal blindness to hundreds of people, for establishing the world premier artificial cornea program in Washington, and for leading collaborative research to translate innovative engineering technologies into creative clinical solution.鈥�
• Dr. , professor of medicine and director of the , 鈥渇or global recognition as an authority on drug and vaccine development for viral and parasitic diseases through work as an infectious disease physician and immunologist.鈥�
• Dr. , professor of pediatrics and of anesthesiology and pain medicine, and director of the , 鈥渇or outstanding leadership in pediatric anesthesiology and in the care of children with traumatic brain injury鈥� and 鈥渇or internationally recognized expertise in traumatic brain injury and direction of the Harborview Injury Prevention and Research Center for the last decade as an exceptional mentor and visionary leader.鈥�

91探花members who will join the Washington State Academy of Sciences by virtue of their election to one of the National Academies are:

• , professor of biostatistics, 鈥渇or the development of novel statistical models for longitudinal data to better diagnose disease, track its trajectory, and predict its outcomes鈥� and 鈥渇or revolutionizing how dynamic predictors are judged by their discrimination and calibration and has significantly advanced methods for randomized controlled trials.鈥� Heagerty was elected to the National Academy of Medicine in 2021.
• , the Bill and Melinda Gates Chair in Computer Science and Engineering, 鈥渇or foundational contributions to the mathematics of computer systems and of the internet, as well as to the design and probabilistic analysis of algorithms, especially on-line algorithms, and algorithmic mechanism design and game theory.鈥� Karlin was elected to the National Academy of Sciences in 2021.
• , professor emeritus of applied mathematics and data science fellow at the , 鈥渇or inventing key algorithms for hyperbolic conservation laws and transforming them into powerful numerical technologies鈥� and 鈥渇or creating the Clawpack package, which underpins a wide range of application codes in everyday use, such as for hazard assessment due to tsunamis and other geophysical phenomena.鈥� LeVeque was elected to the National Academy of Sciences in 2021.
• , the Benjamin D. Hall Endowed Chair in Basic Life Sciences and an investigator with the Howard Hughes Medical Institute, 鈥渇or advancing our physical understanding of cell motility and growth in animals and bacteria鈥� and 鈥渇or discovering how the pathogen Listeria uses actin polymerization to move inside human cells, how crawling animal cells coordinate actomyosin dynamics and the mechanical basis of size control and daughter cell separation in bacteria.鈥� Theriot was elected to the National Academy of Sciences in 2021.
• , professor and chair of biological structure, 鈥渇or elucidating cellular transformations through which neurons pattern their dendrites, and the interplay of activity-dependent and -independent mechanisms leading to assembly of stereotyped circuits鈥� and 鈥渇or revelations regarding the fundamental principles of neuronal development through the application of an elegant combination of in vivo imaging, physiology, ultrastructure and genetics to the vertebrate retina.鈥� Wong was elected to the National Academy of Sciences in 2021.

New members to the Washington State Academy of Sciences are scheduled to be inducted at a meeting in September.

Providing economic relief to struggling families can lead to another positive effect — fewer cases of child neglect, according to new research by the 91探花.

A 10% increase in a common benefit for low- to moderate-income working families, the Earned Income Tax Credit, led to a 9% decrease in the annual number of reports of child neglect made to child welfare agencies over a 14-year study period. That鈥檚 a significant impact, researchers say, and can inform future social policies.

The study is relevant to current policy actions, as President Joe Biden has recently proposed an as part of his new stimulus plan.

鈥淭he EITC is an important part of the U.S. safety net that has been shown to substantially reduce child poverty. Our results add to growing evidence that policies that improve family economic security can also prevent child maltreatment,鈥� said , a doctoral student at the Evans School of Public Policy and Governance at the UW.

She is lead author of the published Jan. 19 in the journal Child Maltreatment.

Child maltreatment is a common problem in the United States, with an estimated subject to a child protective services investigation before they turn 18. The stress of poverty has been linked to child abuse and family instability, and other research has explored the impact of different economic policies on child-abuse prevention. The 91探花study is the first to focus on the Earned Income Tax Credit 鈥� a program designed to assist lower-income families, often with a tangible benefit in the form of a tax refund 鈥� and its potential association with reports of child maltreatment made to child welfare agencies across the U.S.

The is provided by both the federal government and 28 states, and eligibility and credit size vary with income and family size. 91探花researchers focused on the generosity of refundable state EITCs, noting that such a benefit has been found .

The research team analyzed the number of child abuse and neglect reports to local and state agencies from 2004 through 2017 and the correlation with the EITC program at the state level. The team hypothesized that the more generous a state鈥檚 EITC, the more necessities, such as child care or rent, a family can put the money toward, potentially alleviating some of the stress that can lead to child maltreatment. Over the course of the study period, many states altered their level of benefit as a percentage of the federal tax credit, while others generally held steady. Minnesota, for example, provided an average of 33% of the federal credit, depending on household income, while Oklahoma provided 5% of the federal credit before making its EITC nonrefundable in 2016.

With the child abuse and neglect data, the 91探花team counted all reports of maltreatment, rather than just those reports that were found to be substantiated, reasoning that . Taking all states into account 鈥� those with and without an EITC — during the study period, states averaged nearly 4,400 maltreatment reports per 100,000 children each year.

When annual state EITC benefits were taken into account, the team found maltreatment reports, particularly those of neglect, declined as benefit levels rose: A 10 percentage-point increase in state-level benefits was associated with 241 fewer reports of neglect per 100,000 children. The effect was even more pronounced in the number of neglect reports on children from infancy through age 5, the age range at which .

Put another way, a 10 percentage-point increase in the refundable EITC benefit led to a 9% drop in rates of reported child neglect.

鈥淭his study highlights the importance of investigating the impact of social policies on health. Violence is a health issue with multiple forms, such as child maltreatment. An emerging body of evidence is empirically demonstrating that violence prevention can be an added benefit of social policies that were not necessarily enacted with that specific goal originally. This study is the most recent addition to that literature,鈥� said , an associate professor of epidemiology at the UW, director of the Violence Prevention Section at the , and the principal investigator of the that supported this study.

While child neglect showed a trend, the link between EITC benefits and reports of specific types of abuse 鈥� physical, sexual and emotional 鈥� was not statistically significant. Researchers note that child abuse rates, in general, have declined much more significantly than neglect rates in recent decades, while neglect is found in .

Child neglect, too, may be more distinctly associated with poverty, potentially making some interventions more effective in preventing certain types of maltreatment than others.

鈥淐hild neglect often involves the failure of a caregiver to provide children with necessities, such as food, shelter and basic supervision. Additional income provided to families through the EITC can improve parents鈥� abilities to meet these basic needs,鈥� Kovski said.

Researchers say the findings point to the fundamental value of an economic policy 鈥� the EITC 鈥� as a child-maltreatment prevention strategy. In other words, proactively improving financial stability among families may mitigate the circumstances that lead to child neglect and abuse.

The study was funded by Centers for Disease Control and Prevention and the National Institute of Child Health and Human Development.

Co-authors were of the Evans School of Public Policy and Governance at the UW; and of the 91探花Department of Epidemiology; and of聽 the 91探花Department of Epidemiology, the Harborview Injury Prevention & Research Center and the 91探花Department of Pediatrics.

For more information, contact Kovski at kovskin@uw.edu.

With roughly 109 people dying every day and many others treated in emergency rooms from firearm-related injuries 鈥� which are the second leading cause of death among adolescents 鈥� the Centers for Disease Control and Prevention has, after decades, stepped in to fund critical firearm research.

The CDC on Sept. 23 it would fund 16 studies for a total of more than $7.8 million to understand and prevent firearm violence. The 91探花鈥檚 proposal to study handgun carrying among rural adolescents was awarded a three-year grant totaling roughly $1.5 million.

鈥淭hese awards were made by the CDC after about three decades with no direct funding for this area of research. They herald an era in which we will collectively work with a variety of stakeholders to reduce the burden of this major population health challenge in our communities and beyond,鈥� said , an associate professor of epidemiology in the 91探花School of Public Health who is leading the 91探花study. “This is a historic development and consequential milestone for the field of public health in general, and the science of violence and injury prevention in particular.鈥�

The 91探花study will focus on rural communities where the high levels of firearm access and mortality, cultural influences, attitudes and risks associated with youth handgun carrying are understudied and underserved.

鈥淗andgun carrying is widely recognized as a key risk factor for firearm-related injury among youth living in urban areas, but our knowledge of the culture, scope and developmental patterns of handgun carrying 鈥� as well as its determinants and consequences 鈥� among youth living in rural communities is strikingly limited,鈥� said Rowhani-Rahbar, who is also the co-director of the Firearm Injury & Policy Research Program at Harborview Injury Prevention & Research Center.聽“This new project will build on about two decades of foundational research conducted by our colleagues in the at the 91探花.”

The 91探花study will use existing data and collect new data from rural adolescents to:

• Identify opportunities and barriers in firearm injury prevention by improving our understanding of the cultural context of handgun carrying among rural adolescents.
• Determine specific developmental points of intervention by characterizing patterns of handgun carrying in rural communities from early adolescence to young adulthood.
• Examine individual and social-developmental factors that distinguish patterns of handgun carrying in rural communities from early adolescence to young adulthood.
• Test the effect of the Communities That Care prevention system on developmental patterns of handgun carrying among adolescents living in rural communities.

鈥淭he goal of this project is to fill this knowledge gap and provide actionable evidence for informing strategies that can prevent firearm-related injury and promote safety among adolescents in rural communities,鈥� said Rowhani-Rahbar.

The study will be conducted through a collaboration with investigators from UW’s Social Development Research Group, Washington State University, Arizona State University and Seattle Children’s Research Institute.

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For more information, contact Rowhani-Rahbar at rowhani@uw.edu.

In the United States, individual state laws barring 18- to 20-year-olds from buying or possessing a handgun make little difference in the rate of homicides involving a gun by people in that age group, a new 91探花 has found.

鈥淭he central issue is that there鈥檚 a very high degree of informal access to firearms, such as through family members or illicit channels,鈥� said , the study鈥檚 lead author and a doctoral student in epidemiology in the 91探花School of Public Health. 鈥淎nd we can鈥檛 address that kind of availability with age limits.鈥�

The 91探花study compared homicide rates involving firearms in this age group between five states that increased the minimum age to buy or possess a firearm to higher than the set by the 1994 federal law and the 32 states that did not.

The five states were Massachusetts, Maryland, New Jersey, New York and Wyoming. With the exception of Wyoming, these states also increased the minimum age for possession of a handgun. (States that raised age limits before 1994 were not included. Washington was not included for this reason, and the initiative passed in 2018 increasing age limits became law after the study period, which was 1995 to 2017.)

In the study, published Aug. 31 in JAMA Pediatrics, 91探花researchers found that rates of firearm homicides perpetrated by young adults age 18 to 20 years old were not significantly different in the two groups of states.

Determining what laws do have an effect on homicide rates is paramount, she added, because of the roughly 275,000 homicides involving a firearm during the years studied nearly 36,000 were perpetrated by people in the study鈥檚 age range. Because most handguns used in crimes by young adults are acquired from sources unlikely to be affected by age restrictions, 鈥渋t is not surprising that we found no association鈥� between state laws and homicides, the study said.

Also, Moe emphasized, firearms are the second leading , after motor vehicle crashes.

鈥淚t鈥檚 incredibly important that we address this major cause of death in young people,鈥� said Moe, who is also affiliated with the Harborview Injury Prevention & Research Center. And that solution will need to be a countrywide, unified effort to address the 鈥渄e facto availability鈥� of firearms, especially among youth.

Co-authors include Miriam Haviland and Andrew Bowen, Harborview Injury Prevention & Research Center; Ali Rowhani-Rahbar and Frederick Rivara, 91探花Department of Epidemiology, Harborview Injury Prevention & Research Center and the 91探花Department of Pediatrics. This research was funded by the state of Washington.

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For more information, contact Moe at cmoe2@uw.edu.

Roughly one-third of young males and 1 in 10 females in rural communities have carried a handgun, reports a new 91探花 study. And, the study found, many of those rural kids started carrying as early as the sixth grade.

鈥淭his is one of the first longitudinal studies of rural adolescent handgun carrying across multiple states in the U.S.聽It provides evidence that youth handgun carrying in these settings is not uncommon,鈥� said lead author , a 91探花associate professor of epidemiology and co-director of Firearm Injury & Policy Research Program at Harborview Injury Prevention & Research Center.

The study of rural communities across the country, in the Journal of Adolescent Health, also found the practice was associated with pro-handgun attitudes and with having friends who carry handguns.

Knowing that some kids as young as 12 report carrying a handgun indicates that firearm violence and injury-related prevention programs may need to be introduced early in a child鈥檚 life, researchers say.

鈥淵outh handgun carrying and firearm violence are often presented as an exclusively inner-city problem,鈥� said Dr. Rowhani-Rahbar, who is the Bartley Dobb Professor for the Study and Prevention of Violence in the 91探花School of Public Health. 鈥淗owever, that focus should not come at the cost of ignoring non-urban settings. Indeed, youth in some rural areas experience similar or even higher rates of handgun carrying and certain forms of interpersonal violence 鈥撯�� for example, being attacked or threatened with a weapon 鈥撯�� than their counterparts in urban areas.鈥�

Specifically, the researchers found:

• In sixth grade, 11.5% of males and 2.8% of females had carried a handgun within the past year.
• From the sixth grade to age 19, 33.7% of males and 9.6% of females reported carrying at least once during that time.
• Of those who carried, 34% of males and 29.3% of females had carried a handgun for the first time in the sixth grade. However, of those who carried, a majority of both sexes carried a handgun only once over the seven years.
• More kids who carried had friends who did the same. For instance, in the 10th grade, 63% of males who carried had a friend who carried. And of those young males who had not carried a handgun, only 6% had a friend who did. The same pattern was apparent for females.
• A far higher percentage of kids who carried also endorsed pro-handgun norms. For instance, they were much more likely to view taking a handgun to school or work as 鈥渘ot very wrong鈥� than their non-carrying peers.

The study of handgun carrying among rural youth is based on 2,002 kids who started answering survey questionnaires in the sixth grade when they lived in 12 rural communities in seven states. Participants took annual surveys over a seven-year period, 2005 to 2012, as part of the 鲍奥鈥檚 . That larger study is designed to evaluate the university鈥檚 program, which helps communities take a broad approach to preventing youth problem behaviors.

The 12 communities included in the new study had been randomly selected to not implement the Communities That Care prevention program, which has been found to reduce a variety of risky behaviors among youth, including carrying a handgun.

鈥淲e looked at handgun questions only in the control communities, those that did not receive the risk prevention program,鈥� Dr. Rowhani-Rahbar explained. 鈥淭his is because we did not want to measure the effect of the Communities That Care intervention in this study. We wanted to characterize the age at initiation, prevalence and patterns of handgun carrying in the absence of the intervention.鈥�

The dangers of young people鈥檚 exposure to guns are well-documented 鈥撯�� firearm injury is second only to vehicle crashes as a among U.S. kids, with 65% of those deaths resulting from a conflict with another young person. Carrying firearms adolescent bullying, physical fighting and assault. The researchers also point out that federal law prohibits people under age 18 from possessing a handgun.

This is just the first step toward studying health effects, Dr. Rowhani-Rahbar said. A lack of foundational information about youth handgun carrying in rural settings means studies of the causes and consequences of this behavior have also been missing. The team now plans to study these factors 鈥撯�� risk of violence or injury among rural youth who carry a handgun compared to those who do not, for instance 鈥撯�� in the near future.

The Communities That Care program and its youth development study are run by the 91探花School of Social Work鈥檚 .

Co-authors are Sabrina Oesterle, who is now at Arizona State University and worked on this study while with the Social Development Research Group in the 91探花School of Social Work; and , a research scientist with the Social Development Research Group. This research was funded by the National Institutes of Health.

While waiting for free firearm storage devices at gun safety events held in sporting goods stores across Washington, nearly 3,000 people filled out a one-page survey asking how they stored guns at home and other household information.

What the participants reported emphasizes the need for these public events, Seattle Children’s and 91探花 researchers say, because 40% of gun owners at the events reported having at least one firearm in their home that was not locked up. In addition, 39% of survey takers indicated they kept a loaded gun at home, and 14% stored all guns unlocked and loaded.

鈥淓ven in this population, which clearly had some interest in or awareness of firearm safety, there was a high prevalence of unlocked firearms,鈥� said lead author , who worked on the study while a graduate student at the 鲍奥鈥檚 School of Public Health and as an intern with Harborview Injury Prevention & Research Center’s summer research program.

Furthermore, results of surveys conducted at the events in 10 Washington cities between 2015 and 2018 determined that the presence of children in the home did not make a difference. The study is and is part of the February 2020 edition of the journal Preventative Medicine.

The firearm safety events were put on by Seattle Children’s in partnership with 91探花Medicine鈥檚 , public health agencies, local hospitals in each city, community organizations and coalitions.

In addition to taking a survey and receiving a free firearm lockbox or trigger lock, people at the public events received training on safe firearm storage and proper use of storage devices. The events were held in Monroe, Tacoma, Kirkland, Wenatchee, Seattle, Lacy, Mount Vernon, Moses Lake, Silverdale and Federal Way.

鈥淭he purpose of the events is to increase the use of safe firearm storage, an evidence-based strategy to reduce firearm related injuries and deaths,鈥� said Elizabeth Bennett, co-author and director of community health and engagement at Seattle Children鈥檚. 鈥淥ur goal is to create a comfortable environment to learn about locking up firearms and to have the devices ready to use right away.鈥�

Public gun safety events are an effective tool for improving the safety of kids living around firearms, a found, and the events reach an key audience: male gun owners.

This is an important demographic to reach, King said, because men make up the majority of gun owners and typically take responsibility for how guns are stored in the home. When gun safety interventions are held in pediatrician offices or similar clinic settings, most parents or guardians who attend .

Importantly, nearly all of the roughly 3,000 who submitted surveys said they planned to use the free safety device within the following week. Storing firearms locked and unloaded, the researchers point out, is associated with a greater-than 70% reduction in risk of unintentional and self-inflicted firearm injuries among young people.

King, who is currently a project coordinator at Columbia University, added that when it comes to firearm storage some adults might think that younger children don鈥檛 know where the guns are or don鈥檛 know how to access them, but that is not always the case.

鈥淎 lot of times, the kids do know,鈥� King said. 鈥淎lso, guardians might think that training adolescents or older children is enough to keep them safe, that training means they don鈥檛 have to lock their guns. Unfortunately, a lot of adolescents are at high risk of suicide, and unlocked guns add to that risk 鈥� regardless of training.鈥�

Co-authors include , Department of Global Health, 91探花schools of Medicine and Public Health; ,聽the Bartley Dobb Professor for the Study and Prevention of Violence, Department of Epidemiology, 91探花School of Public Health; Joseph Simonetti, University of Colorado School of Medicine and Veterans Health Administration, Colorado; and Cassie Simeona and Lauren Staneck, Seattle Children鈥檚.

Learn more about the 鲍奥鈥檚 Population Health Initiative: a 25-year, interdisciplinary effort to bring understanding and solutions to the biggest challenges facing communities.

When those children come from low-income households with limited English proficiency, there can be significant barriers in getting them the care they need.

A recent 91探花 found that less than 20 percent of rehabilitation providers in the state accepted Medicaid and also provided language interpretation to children with traumatic brain injuries. Just 8 percent provided mental health services to those children, and Spanish-speaking families had to travel significantly further to access services.

The findings highlight how already disadvantaged children are further impacted by limited access to the rehabilitation services that vastly improve long-term outcomes, said lead author , the Sidney Miller Endowed Assistant Professor in Direct Practice at the 91探花School of Social Work and a core faculty member at the 91探花.

鈥淩ehabilitation after a brain injury is incredibly important, especially for kids with moderate to severe brain injuries,鈥� Moore said. 鈥淯ltimately, that limited availability is going to impact children鈥檚 outcomes.鈥�

For the study, published in the in March, the researchers compiled a database of 293 health providers around Washington offering physical and occupational therapy; speech, language and cognitive therapy; and mental health services. A research assistant called each provider and asked about the types of services offered, whether Medicaid was accepted and if interpretation was available for non-English-speaking families.

The research found that:

• Only 46 percent of providers accepted children with Medicaid
• Children covered by Medicaid had fewer rehabilitation services available than those covered by private insurance
• In each of the three general areas of health care listed above, there were fewer services for children whose families needed language interpretation
• While mental health services comprised more than half of the rehabilitation services available, only 8 percent of those providers accepted children with Medicaid who needed language services
• Less than half of the physical and occupational services accepted children with Medicaid and provided language services
• In total, less than 20 percent of all providers accepted children with Medicaid and also provided language services

The researchers also looked at travel times for 82 children with moderate to severe traumatic brain injuries who were treated at Harborview Medical Center, using data from a study. They found that regardless of their child鈥檚 insurance status, Spanish-speaking parents had to drive an average of 16 minutes more than English-speaking parents to reach a mental health provider, and they had to travel an additional nine minutes to get to physical, occupational, speech and cognitive therapy.

The study found that more diverse counties also had fewer multilingual rehabilitation services 鈥� for every 10 percent increase in of non-English speakers over the age of 5 at home, there was a 34 percent drop in the availability of those services.

The inequities may be even greater than the study shows, the researchers note, since providers who accept Medicaid may routinely limit the number of Medicaid-covered children that they accept, due to lower reimbursement rates.

The study follows earlier 91探花 which found disparities in outcomes among Latino children after traumatic brain injuries. The researchers wondered whether the disparities might have to do with a lack of rehabilitation services generally, but instead identified an access issue for low-income children from families with limited English proficiency.

That gap is particularly worrisome given the state鈥檚 increasing diversity 鈥� more than 18 percent of households in Washington spoke a language other than English in 2012, the study notes, and almost half of children younger than 18 had Medicaid insurance in 2011.

Joana Ramos, co-chair of the , said advocates regularly hear that families are being turned away from health care providers or being required to provide their own interpreters.

鈥淚t鈥檚 a huge problem, and we definitely need to get everybody on board to address it, not just the advocates,鈥� she said. 鈥淟anguage services need to be a routine part of health care services, not a standalone thing.鈥�

Moore said since the bulk of rehabilitation after a brain injury takes place in the community, workers at the hospitals where children are initially treated should try to connect parents with services before they leave.

鈥淲e need to be thinking more critically about how we transition kids back to the community, particularly children we know have limited access to services,鈥� she said. 鈥淲e really have to do a thorough job of linking them to these services on the outpatient side.

鈥淜nowing what we know now, it鈥檚 a social justice obligation.鈥�

The research was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health and the National Institute of Child Health and Human Development.

Co-authors are , an anesthesiologist at Children鈥檚 Hospital; , an assistant professor of epidemiology at the 91探花School of Public Health; , a graduate student at Boston College; Kate Baron, a research assistant at Harborview Injury Prevention Center; , director of support programs at the Brain Injury Alliance of Washington; , executive director of the Brain Injury Alliance of Washington; , professor and vice president of academic affairs at the 91探花Department of Pediatrics; , a professor of rehabilitation medicine and adjunct professor of pediatrics and neurological surgery at 91探花Medicine; and , a 91探花professor of pediatrics.

For more information, contact Moore at mm99@uw.edu or 206-616-2862.