25 and counting

Little known fact: Florida’s Healthy Kids public-private children’s insurance program served as a model for the national Children’s Health Insurance Program, helping uninsured children all across the U.S. get much-needed health care.

The idea for the program was sparked by a revolutionary idea UF faculty member Stephen A. Freedman, Ph.D., published in The New England Journal of Medicine in 1988.

Freedman found that roughly two-thirds of uninsured people in the United States were school-age children and their families, so he proposed providing health insurance to them through school enrollment. It was a way to reap the benefits of covering a large group of people — because insurance rates for organizations with large groups of employees have always been lower than for smaller groups — in a new way and provide care to needy children at the same time.

The idea formed the basis for Florida’s Healthy Kids program, which later combined with two other programs to become Florida KidCare, and also served as a model for the 1997 national Children’s Health Insurance Program.

It was also one of the first major achievements of the Institute for Child Health Policy, or ICHP, which was founded at UF in 1988. Freedman served as the institute’s founding director.

“ICHP was initially started as a forum to try and bring evidence-based information to policymakers to help them improve the health of children,” said Elizabeth Shenkman, Ph.D., the current director of the institute, who came to UF in 1992, four years after the institute was founded. “The idea was ahead of its time.”

After 25 years, the program has evolved from not only providing lawmakers with information and analysis they need to serve the state’s children, but also to becoming a thriving research enterprise, with 17 faculty researchers working on studies and programs that benefit children across the nation. The institute’s faculty researchers have led groundbreaking work that has helped shape health care and public policies to protect and promote child health.

Two main areas of the institute’s research include prevention science to inform public and institutional policies for health promotion and disease prevention, and implementation science to promote the integration of research findings and evidence into health care practice and health policy. Research initiatives include studies on access to and quality of health care and health promotion and disease prevention. The institute’s research is primarily focused on achieving optimal health and health equity among all children, with a focus on reducing health disparities among children from low-income families and from racial and ethnic minority groups.

Last year alone, ICHP researchers received $12 million in grant funding from the National Institutes of Health, the Robert Wood Johnson Foundation and other prestigious funding agencies.

Shenkman leads the team that focuses primarily on increasing access to and quality of health care, with ICHP faculty Jill Boylston Herndon, Ph.D., I-Chan Huang, Ph.D., Caprice Knapp, Ph.D., Melanie Hinojosa, Ph.D., and Ryan Theis, Ph.D.

In 2004, Shenkman recruited Kelli Komro, Ph.D., and Alexander Wagenaar, Ph.D., to expand the scope of work to include community prevention and public policy studies. They subsequently recruited Mildred Maldonado Molina, Ph.D., Stephanie Staras, Ph.D., and Sarah Lynne-Landsman, Ph.D.

As part of its evolution, ICHP has evolved from providing analysis and data to working with experts in numerous fields to shape not only policies but also community-based interventions that directly help children.

“We really wanted to bring a multidisciplinary perspective to children, addressing not only policy but also quality and outcomes of care, and we did that,” Shenkman said. “We have accomplished that in the last decade, addressing children’s health in different venues. We brought together a really dynamic multidisciplinary group. All of us overlap. At the end of the day, it’s about doing what is best to help improve the health of children.”