VERO BEACH, Fla. - Jay Cuff winces and shouts, "Ow!" He is feeling the pinch.
The 12-year-old is getting four immunizations at the Indian River County Health Department in Vero Beach.
Jay's mom, Tatasha Dawkins, has been through this before; she has three kids.
"It can be expensive because when they're breaking legs, fingers, toes," she laughed.
All three of Dawkins' kids have had Medicaid since birth. Dawkins says she would be hard-pressed to pay for private medical care for all of them.
More Indian River County parents are finding themselves in that position. Medicaid enrollment has grown 65 percent from 2008 to 2011. That's according to a new, 140+-page health assessment the Health Council of Southeast Florida compiled for the county's health department.
"Now we'll be able to analyze the data and figure out what our priorities are," said Miranda Hawker, Indian River County Health Department administrator. She said a state grant paid for the assessment.
The assessment also found more than a quarter of Indian River children are living in poverty and that food stamp issuance increased more than 250 percent from 2008 to 2011.
"It certainly paints a picture that that's a need in our community," said Hawker.
The number one cause of death is cancer. Hawker says the infant population is growing at a disproportionate rate.
There were positives, too. Hawker says Indian River ranks number two in the state for dental care to people who earn a low income. And the number of uninsured people decreased, although it's still an area of concern.
"We want to improve the community's health. That's our mission, and so this matters. The health of our community and the health of our residents matter," said Hawker.
The next step is for a health advisory council to look at the assessment and form a plan of action to improve community health and health care access. Hawker says that should take about two months. The community will provide input before it's finalized.
Dawkins says the plan should start at home, with parents. "They need to focus more on the kids and how they feel and how they think."
You can find the community health assessment in its entirety here .