The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71073

Jon M. Thompson, PhD¹, Steven W. Evans, PhD², and Elizabeth M. Dahmus, MSN, RN². (1) Department of Health Sciences, James Madison University, MSC 4301, 3134 HHS Building, Harrisonburg, VA 22807, 540/568-3472, thompsjm@jmu.edu, (2) Department of Psychology, James Madison University, MSC 1902, Harrisonburg, VA 22807

Barriers to care exist for many Americans, and therefore access to needed health services is severely constrained. Barriers to care include both direct and indirect factors, and these have been well documented. Less known in empirical studies of access is the relationship of barriers to care to the use of different types of services, and perceived health status. For children, barriers to care can set up a vicious cycle of lack of access, increasing unmet needs, and the development of chronic health problems that were avoidable. In this study, we test several relationships between perceived barriers to care, children's use of health services, and perceived health status of children using multivariate models that address medical, mental health and dental health services. The data is based on representative sample responses (n=459) to a 2001 household survey conducted in both rural and urban areas of a large mid-Atlantic state. The study uses Aday and Andersen's classic model of access to care, which specifies predisposing, enabling and need factors, as a framework for defining barriers to care. Findings suggest that barriers reflecting enabling and predisposing factors are significantly related to children's use of health services and perceived health status. More importantly, these barriers differentially affect use of mental health, medical and dental services, as well as perceived health status of children in each of these service domains. Implications of study findings for community-wide efforts to reduce barriers to care and improve services to children are presented.

Learning Objectives:

At the end of this session, the participant will be able to:
• define prediposing and enabling factors that serve as barriers to mental health, medical and dental health care for children.
• understand the relationship of barriers to use of medical, mental health and dental health services, and perceived health status, among children.
• identify suggestions for change in local communities to reduce barriers to care based on study findings.

Keywords: Access to Care, Children's Health

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: This research is funded by the Commonwealth Health Research Board, Richmond, Virginia.