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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Gilbert Liu, MD, MS, Department of Pediatrics, Indiana University, 702 Barnhill Dr, Riley Research Wing, Rm 344, Indianapolis, IN 46202, Kim D. Jaffee, PhD, School of Social Work, Syracuse University, Sims Hall, Syracuse, NY 13244, (315)443-4017, gcliu@iupui.edu, Nancy Swigonski, MD, MPH, Department of Adolescent Medicine, Indiana Unviersity School of Medicine, Riley Hospital, 702 Barnhill Road, Room 1740X, Indianapolis, IN 46201, and Janie L. Canty-Mitchell, PhD, School of Nursing, Indiana University, 1111 Middle Drive, NU 461, Indianapolis, IN 46202.
Background: The impact of community context on CSHCN, a group that is vulnerable to behavioral and emotional problems (BEP), is not well studied. Methods: Primary caregivers (n=208) of CSHCN were recruited from clinics in a large Mid-western city. Eligibility included enrollment in Medicaid or SCHIP, positive screening for CSHCN (Living with Illness Measure), English speaking, telephone at home, and non-Hispanic Black or White children ages 2-18y. Caregivers were interviewed using a computer-assisted telephone questionnaire. Urban stressors were measured using the Urban Life Stressor Scale (ULSS). BEP were measured using the Child Behavior Checklist (CBCL). ULSS factors were defined by Varimax rotation and scree plot. ANOVA was used to examine the association between ULSS and CBCL scores. Results: CSHCN with evidence of BEP (CBCL score >=63) had higher ULSS scores (mean 26.3 vs. 21.4; p<.001). There were no differences between black and white children’s ULSS scores (mean 24.0 vs. 22.4). Three ULSS factors were examined as risks for BEP: “Financial”, “Social”, and “Neighborhood”. For the total cohort, as well as in separate analyses by race, those with CBCL scores >=63 had higher “Financial” and “Social” stressor scores. Conclusion: Few studies examine the adverse impact of community context on CSHCN mental health. Of those that do, inadequate access to care is put forward as explaining the relation between urban stress and BEP. In this high-risk CSHCN sample who were insured and had appointments in a primary care clinic, urban stress remained associated with emotional and mental health problems.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to
Keywords: Children With Special Needs, Mental Health Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.