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Disparities in primary care for vulnerable children: the influence of multiple risk factors

Gregory D Stevens1, Michael Seid, Ritesh Mistry

  • 1Division of Community Health, USC Keck School of Medicine, CA, USA.

Health Services Research
|April 6, 2006
PubMed

Insights

Children with multiple risk factors face poorer health and reduced access to primary care. However, they may receive more health promotion counseling once access is gained, highlighting care disparities.

Area of Science:

  • Pediatric Health Services Research
  • Health Disparities
  • Vulnerable Populations

Background:

  • Vulnerability in pediatric care is often assessed by individual risk factors.
  • A comprehensive profile of multiple risk factors can better identify disparities in child health and healthcare experiences.

Purpose of the Study:

  • To analyze vulnerability as a profile of multiple risk factors impacting pediatric care.
  • To examine disparities in child/adolescent health status and primary care experiences based on these risk profiles.

Main Methods:

  • Utilized cross-sectional data from 19,485 children/adolescents (0-19 years) from the 2001 California Health Interview Survey.
  • Employed multiple logistic regression models to assess risk profiles in relation to health status and primary care access, continuity, and comprehensiveness.

Main Results:

  • Approximately 43% of California children had two or more risk factors.
  • An increasing number of risk factors correlated with poorer self-reported health status (p<.001).
  • Higher risk profiles were linked to decreased primary care access and continuity, but increased receipt of health promotion counseling.

Conclusions:

  • A dose-response relationship exists between higher risk profiles and poorer child health status, access, and continuity of primary care.
  • Adolescents with higher risk profiles were more likely to receive health promotion counseling after gaining access.
  • Vulnerable children with greater healthcare needs face significant barriers to accessing primary care.
Abstract

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