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Published on: December 31, 2017
Pre-Pandemic and Recent Oral and Medical Health Care Utilization among Young American Indian Children and Their
Steven D Barger1,2, Christine Kirby3, Heather Thomas4
1Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, USA. Steven.Barger@nau.edu.
Insights
Preventive health care for American Indian (AI) children saw increased utilization post-COVID, with oral health check-ups rising significantly. AI caregivers reported more delays due to the pandemic than cost barriers.
Area of Science:
- Public Health
- Pediatric Dentistry
- Health Services Research
Background:
- American Indian (AI) children face disproportionately high rates of dental caries.
- The COVID-19 pandemic disrupted healthcare access, raising concerns about continuity of care for vulnerable populations.
- Limited data exists on the resumption of preventive oral health services for AI children post-pandemic.
Purpose of the Study:
- To assess recent preventive oral and medical health care utilization among young AI children (0-5 years) after COVID-19 lockdowns.
- To compare recent utilization with pre-COVID-19 levels and national estimates.
- To examine caregiver-reported barriers to health care access.
Main Methods:
- Survey of 152 adult AI caregivers of children aged 0-5 years.
- Assessed 12-month preventive oral and medical health services, comparing to pre-COVID periods for older children (3-5 years).
- Investigated caregiver-reported reasons for delaying or forgoing health care.
Main Results:
- For children aged 3-5, both medical (90%) and oral (78%) health care utilization were high in the past year.
- Oral health check-ups increased from 44% pre-COVID to 62% in the past year.
- Reported preventive medical (99%) and oral (96%) care utilization exceeded national estimates.
- More caregivers delayed care due to COVID-19 (28-38%) than cost (8-17%).
Conclusions:
- Recent preventive health care utilization for young AI children appears robust and comparable between oral and medical services post-lockdown.
- Despite high utilization, pandemic-related disruptions impacted care access for a notable proportion of caregivers.
- Findings suggest a potential resilience and even increase in preventive care seeking among this population.
Abstract:
Children from diverse ethnic groups are at significantly increased risk for dental caries. In particular, American Indian (AI) children have the highest incidence of detal caries of any ethnic group. The COVID-19 pandemic dramatically restricted health care access, including preventive oral health care. Given this context, it is unclear whether or not preventive oral health care for AI children has resumed since lockdown. To address this question, we surveyed adult AI caregivers (N = 152) of children aged 0-5 years, assessing recent (12-month) and pre-COVID (for caregivers of children aged 3-5 years) preventive oral and medical health services. We also examined medical health care access and utilization among caregivers. Among children aged 3-5 years old, both pre-pandemic and past year medical care utilization were generally high (80 and 90%, respectively) as was any oral health care utilization (64 & 78%, respectively). Oral health check-ups were more common over the last year (62%) compared to pre-COVID (44%). Recent health care utilization among children 1-5 years old in this sample were generally comparable to national estimates, except for higher reported preventive medical care (99% vs. 87.6%, respectively) and higher preventive oral care (96% vs. 59.6%, respectively). More caregivers reported delaying or foregoing needed health care due to COVID (28-38%) versus due to cost (8-17%). In this survey of AI caregivers, recent child preventive health care utilization was high, and changes in utilization following the lockdown phases of the pandemic were comparable for oral and medical health care.
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