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Maternal factors and child's health care use
1Department of Psychology, University of Washington, Seattle 98104, USA.
Insights
Maternal substance abuse, depression, and low social support did not predict increased pediatric healthcare use, including emergency room visits or immunization delays, in this study. Further research is needed to understand these associations.
Area of Science:
- Pediatric Health Services Research
- Social Determinants of Health
- Maternal and Child Health
Background:
- Limited data exists on the link between psychosocial factors and pediatric healthcare utilization.
- Understanding these associations is crucial for improving child health outcomes and resource allocation.
Purpose of the Study:
- To investigate the association between maternal substance abuse, depression, low social support, and pediatric healthcare use.
- To examine the relationship with medical visits, emergency room use, injury-related visits, and immunization delays.
Main Methods:
- Prospective study of 202 U.S. families with preschool children in an inner-city clinic.
- Standardized questionnaires assessed maternal psychosocial factors; medical records tracked healthcare use.
- Regression analysis controlled for maternal and child age.
Main Results:
- 37% of mothers screened positive for substance abuse, 34% for depression, and 60% for low social support.
- Children averaged 8.6 clinic visits, 41% had an ER visit, and 43% had immunization delays.
- None of the assessed psychosocial factors significantly predicted healthcare use outcomes after controlling for covariates.
Conclusions:
- The study found no significant association between maternal psychosocial factors and pediatric healthcare utilization in this population.
- Further research with larger, diverse cohorts may be needed to elucidate complex relationships.
- Findings highlight the need for targeted interventions and support for vulnerable families.
Abstract:
There is inadequate data about the association between specific psychosocial factors and pediatric health care use. We hypothesized that maternal substance abuse, depression, and low social support would be associated with increased medical visits, emergency room (ER) use, visits for injuries and delays in immunization. We conducted a prospective study of 202 U.S. families with preschool children in a clinic serving the inner city poor. Psychosocial factors were assessed from standardized screening questionnaires for substance abuse, depression and low social support. Research assistants blind to the study hypothesis reviewed medical records for health care over the year following completion of the questionnaire: number of clinic visits, use of emergency room, visits to the ER or clinic for injuries, and delays in immunizations of two months or more. Among the 202 mothers, the mean age was 24.4 years, 47% were African American, 32% Caucasian, and 14% Asian; 55% were high school graduates. The average household income was $7620 per year; the mean age of children was 12.2 months. Thirty-seven percent of mothers screened positively for substance abuse, 34% for depression, and 60% for low social support. Children had an average of 8.6 clinic visits per year; 41% had an ER visit, 21% had an injury resulting in an ER or clinic visit, and 43% of children under 2 years of age had a delay of 2 months or more in recommended immunizations. After controlling for maternal and child age in a regression equation, none of the psychosocial factors were significant predictors of health care use outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)