Maternal Disability and Early Child Preventive Care
Hilary K Brown1,2,3,4, Clare Taylor5, Andi Camden1,6,4
1Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada.
Insights
Children of mothers with intellectual or developmental disabilities had fewer well-child visits and immunizations. This highlights a need for improved access to preventive health care for this vulnerable population.
Area of Science:
- Pediatric Health
- Disability Studies
- Public Health
Background:
- Preventive health care, including well-child visits and immunizations, is crucial for child development.
- Mothers with physical, sensory, or intellectual or developmental disabilities often face barriers to their own healthcare.
- It remains unclear if these barriers extend to the preventive healthcare access for their young children.
Purpose of the Study:
- To investigate disparities in preventive health care access for young children whose mothers have various types of disabilities.
- To compare the rates of well-child visits, immunizations, and developmental screenings between children of mothers with and without disabilities.
Main Methods:
- A population-based study in Ontario, Canada, analyzed data for children born between 2012 and 2019.
- Included mothers with physical, sensory, intellectual/developmental disabilities, multiple disabilities, or no disability.
- Primary outcomes: receipt of recommended well-child visits and immunizations in the first two years; secondary outcomes: developmental assessments and screenings. Adjusted relative risks (aRR) were calculated.
Main Results:
- Children of mothers with intellectual or developmental disabilities were less likely to receive recommended well-child visits (aRR 0.92) and routine immunizations (aRR 0.88).
- These children also had lower rates of enhanced 18-month developmental assessment (aRR 0.92) and any developmental screen (aRR 0.94).
- No significant disparities were observed for children of mothers with physical or sensory disabilities compared to those without disabilities.
Conclusions:
- Children born to mothers with intellectual or developmental disabilities experience significant disparities in accessing essential preventive health care services.
- Targeted resources and interventions are needed to improve healthcare access for young children of mothers with intellectual or developmental disabilities.
- Further research should explore the specific barriers contributing to these disparities to inform policy and practice.
Objectives:
Preventive health care for children comprises routine well-child visits and immunizations. Women with physical, sensory, or intellectual or developmental disabilities tend to experience more barriers to preventive health care; yet it is unknown whether such barriers are observed among their young children.
Methods:
This population-based study in Ontario, Canada included children born between 2012 and 2019 whose mothers had a physical (n = 74 084), sensory (n = 26 532), or intellectual or developmental (n = 1391) disability, multiple disabilities (n = 5774), or no disability (n = 723 442). Primary outcomes were receipt of the recommended number of well-child visits and routine immunizations in the first 2 years. Secondary outcomes included receipt of the enhanced 18-month developmental assessment and any developmental screen. Relative risks (aRR) were generated using modified Poisson regression and adjusted for maternal sociodemographics and mental health and child sex.
Results:
Compared with children of mothers without disabilities, those whose mothers had intellectual or developmental disabilities were less likely to receive the recommended number of well-child visits (56.3% vs 63.2%; aRR 0.92, 95% confidence interval [CI] 0.88-0.97), routine immunizations (43.8% vs 53.7%; aRR 0.88, 95% CI 0.83-0.94), enhanced 18-month developmental assessment (52.3% vs 60.8%; aRR 0.92, 95% CI 0.88-0.97), or any developmental screen (54.9% vs 62.5%; aRR 0.94, 95% CI 0.90-0.99). Other disability groups did not experience such disparities.
Conclusions:
There is a need to develop resources to improve access to preventive health care for young children of women with intellectual or developmental disabilities.
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