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APHA Scientific Session and Event Listing

Julia Ana Drew, BA, Department of Sociology, Brown University, Box 1916, Providence, RI 02912, 401 454 4208, julia_drew@brown.edu

This paper critically assesses the popular CSHCN Screener developed out of the CAHMI initiative and is organized around the question: “Does the CSHCN Screener produce systematically biased estimates of children with special health care needs (CSHCN)?” Because a long tradition of scholarship has established higher rates of morbidity among minorities, we would expect that, if the CSHCN Screener is producing valid estimates of CSHCN, then consistent with previous literature we will see that minority children are identified at disproportionately higher rates than White children. However, if the CSHCN Screener is indeed biased, we will see that, even conditional on diagnosis of a chronic health condition, minority children will be less likely to be identified by the CSHCN Screener than White children. I use the 2002 National Health Interview Survey (NHIS) focal child sample to test the hypotheses raised here. Unlike the 2001 National Survey of CSHCN, the 2002 NHIS provides in-depth information on morbidity and health care access for all children sampled. Findings indicate that African American children experienced a higher prevalence, on average, than non-Hispanic White children of functional limitations related to a chronic health condition and of diagnosed chronic health conditions such as sickle cell anemia, mental retardation, learning disabilities, and asthma. However, non-Hispanic White children were 25% more likely to be identified by the CSHCN Screener, net of health insurance coverage and medical home access. Implications for future research include a call to reconsider the CSHCN Screener as the “gold-standard” for producing population-level estimates of CSHCN.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Critically assess whether the CSHCN Screener is systematically mis-identifying minority children in its estimates of CSHCN

Keywords: Children With Special Needs, Population

Presenting author's disclosure statement:

Not Answered