Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114168

Lewis H. Margolis, MD, MPH, Department of Maternal and Child Health, University of North Carolina, Rosenau Hall, Chapel Hill, NC 27599-7445, 9199665974, lew_margolis@unc.edu, Michelle Mayer, PhD, MPH, RN, Department of Health Policy and Administration, University of North Carolina, School of Public Health, Chapel Hill, NC 27599-7590, Anita M. Farel, DrPH, Maternal and Child Health, School of Public Health, 426 Rosenau Hall, CB# 7445, University of North Carolina, Chapel Hill, NC 27599-7545, and Kathryn A. Clark, PhD, Department of MCH, University of North Carolina, Rosenau Hall, University of North Carolina, Chapel Hill, NC 27599-7445.

The devolution of public health responsibilities to state and local levels of government has been taking place since the creation of the MCH Services Block Grant (MCHSBG) in 1981. While the MCHSBG provides core funding for infrastructure, population-based services, enabling services, and gap-filling for clinical and other services that may not be readily available, the capacity of MCH agencies or programs to meet the needs of the population is a function of multiple political and economic characteristics of the states. This project examines the relationship between a range of state characteristics and the well-being of CSHCN as evidenced by the 2000-2001 National Survey of Children With Special Health Care Needs. For example, one measure of state level capacity is the per capita CSHCN expenditure. Families of children reporting familiarity with Title V or receipt of special education services were in states with higher median per capita expenditures compared to other children. Another measure of capacity is the percentage of Title V funds that are allocated to CSHCN (range: 14% to 79%) in which children from states above the median are more than twice as likely as other children to report that they had received all needed care coordination. Multivariable techniques demonstrate the contributions of different political, economic, and health systems factors to reported well-being suggesting that more attention to the social, political and economic contexts of MCH agency policy and program development may provide a means for strategically planning more effective and, perhaps, more equitable services.

Learning Objectives:

• Identify state-level social, political and economic indicators that have an impact on funding for CSHCN
• Discuss the relationships among these factors and state expenditures as they affect the self-reported well-being of CSHCN
• Prioritize among social, political and economic indicators in order to develop possible strategies for enhancing support for CSHCN

Keywords: Children With Special Needs, Public Policy

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.