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The unmet health needs of America's children
P W Newacheck1, D C Hughes, Y Y Hung
1Institute for Health Policy Studies, University of California, San Francisco, CA 94143, USA.
Insights
Millions of US children face unmet health care needs, particularly dental care. Poverty and lack of insurance significantly increase the likelihood of children not receiving necessary medical, dental, or vision services.
Area of Science:
- Public Health
- Pediatric Health Services Research
- Health Economics
Background:
- Unmet need for health care among children is a critical indicator of healthcare access issues.
- Failure to obtain timely treatment can negatively impact children's current and future health status and functioning.
- Understanding the prevalence and characteristics of unmet needs is crucial for developing effective interventions.
Purpose of the Study:
- To present current prevalence estimates of unmet health care needs in US children.
- To describe the demographic and socioeconomic characteristics associated with unmet health needs in children.
- To utilize nationally representative household survey data for robust analysis.
Main Methods:
- Analysis of 4 years (1993-1996) of the National Health Interview Survey data.
- Inclusion of 97,206 children under 18 years of age.
- Data collection on unmet needs for medical, dental, prescription medication, and vision care via adult household respondents; bivariate and multivariate analyses to assess relationships with child/family characteristics.
Main Results:
- 7.3% (4.7 million) of US children experienced at least one unmet health care need.
- Dental care represented the most common unmet need.
- Children in near-poor and poor households were approximately 3 times more likely to have unmet needs compared to non-poor children. Uninsured children were also about 3 times more likely than privately insured children to have unmet needs.
Conclusions:
- Despite national wealth, unmet health needs persist among US children, highlighting significant access barriers.
- A comprehensive public policy approach is necessary to address both financial and nonfinancial barriers to healthcare access for children.
- Reducing the prevalence of unmet health care needs requires targeted policy interventions.
Objective:
Unmet need for health care is a critical indicator of access problems. Among children, unmet need for care has special significance inasmuch as the failure to obtain treatment can affect health status and functioning in the near- and long-term. The purpose of this study was to present current prevalence estimates and descriptive characteristics of children with unmet health needs using nationally representative household survey data.
Methods:
We analyzed 4 years of National Health Interview Survey data spanning 1993 through 1996. Our analysis included 97 206 children <18 years old. Measures of unmet need for medical care, dental care, prescription medications, and vision care were obtained from an adult household member (usually the mother) responding for the child. Bivariate and multivariate analyses were used to assess the degree to which unmet need was related to the demographic and socioeconomic characteristics of the child and family.
Results:
Overall, 7.3% (4.7 million) of US children experienced at least 1 unmet health care need. Dental care was the most prevalent unmet need. After adjustment for confounding factors, near-poor and poor children were both about 3 times more likely to have an unmet need as nonpoor children (adjusted odds ratio [95% confidence interval] = 2.89 [2.52, 3.32], 3.0 [2.53, 3.56], respectively). Uninsured children were also about 3 times more likely to have an unmet need as privately insured children (adjusted odds ratio [95% confidence interval] = 2. 92 [2.58, 3.32]).
Conclusions:
Despite the nation's great wealth, unmet health needs remain prevalent among US children. A combined public policy that addresses financial and nonfinancial barriers to care is required to reduce the prevalence of unmet need for health care.