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Disparities in Unmet Health Care Needs Among US Children During the COVID-19 Pandemic
Sanjana Pampati1,2, Nicole Liddon3, Elizabeth A Stuart4
1Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia mix2@cdc.gov.
Insights
The COVID-19 pandemic worsened unmet pediatric health care needs, with disparities linked to race, income, and location. Culturally inclusive care is essential for equitable child health access.
Area of Science:
- Pediatric Health Services Research
- Health Disparities
- Public Health
Background:
- The COVID-19 pandemic significantly disrupted pediatric healthcare delivery in the U.S.
- Existing healthcare access barriers were exacerbated by pandemic-related disruptions.
- Characterizing unmet pediatric healthcare needs during this period is crucial for understanding disparities.
Purpose of the Study:
- To investigate and characterize disparities in unmet pediatric health care needs among US children aged 5-12 during the COVID-19 pandemic.
- To identify child, parent, household, and county-level factors associated with forgone care and missed well-child visits.
Main Methods:
- Analysis of data from Wave 1 (Oct-Nov 2020) and Wave 2 (Mar-May 2021) of the COVID Experiences Survey.
- Examined indicators: forgone care, forgone well-child visits, and no well-child visit in the past year.
- Multivariate models adjusted for child, parent, household, and county characteristics, including race/ethnicity and experiences of racism.
Main Results:
- 16.3% of children reported forgone care, 10.9% forgone well-child visits, and 30.1% had no well-child visit in the past year.
- Disparities in unmet needs were linked to child race/ethnicity, health conditions, school instruction mode, parent childcare challenges, household income, and county factors (e.g., physician availability).
- Child and parent experiences of racism were significantly associated with unmet healthcare needs.
Conclusions:
- Findings underscore significant disparities in pediatric healthcare access during the COVID-19 pandemic.
- Emphasizes the need for ongoing research into unmet health needs and culturally inclusive healthcare optimization.
- Interventions should address systemic barriers to ensure equitable pediatric healthcare access.
Purpose:
The COVID-19 pandemic disrupted pediatric health care in the United States, and this disruption layered on existing barriers to health care. We sought to characterize disparities in unmet pediatric health care needs during this period.
Methods:
We analyzed data from Wave 1 (October through November 2020) and Wave 2 (March through May 2021) of the COVID Experiences Survey, a national longitudinal survey delivered online or via telephone to parents of children aged 5 through 12 years using a probability-based sample representative of the US household population. We examined 3 indicators of unmet pediatric health care needs as outcomes: forgone care and forgone well-child visits during fall 2020 through spring 2021, and no well-child visit in the past year as of spring 2021. Multivariate models examined relationships of child-, parent-, household-, and county-level characteristics with these indicators, adjusting for child's age, sex, and race/ethnicity.
Results:
On the basis of parent report, 16.3% of children aged 5 through 12 years had forgone care, 10.9% had forgone well-child visits, and 30.1% had no well-child visit in the past year. Adjusted analyses identified disparities in indicators of pediatric health care access by characteristics at the level of the child (eg, race/ethnicity, existing health conditions, mode of school instruction), parent (eg, childcare challenges), household (eg, income), and county (eg, urban-rural classification, availability of primary care physicians). Both child and parent experiences of racism were also associated with specific indicators of unmet health care needs.
Conclusions:
Our findings highlight the need for continued research examining unmet health care needs and for continued efforts to optimize the clinical experience to be culturally inclusive.
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