192651 Maternal mental health and pediatric health care use: A national sample of Medicaid and SCHIP insured children

Wednesday, November 11, 2009: 8:45 AM

Sara Wiesel Cullen, MSW , School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA
Jason C. Matejkowski, MSW , School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA
Steven C. Marcus, PhD , University of Pennsylvania School of Social Policy and Practice, Philadelphia, PA
Phyllis Solomon, PhD , Social Policy and Practice, University of Pennsylvania, Philadelphia, PA
While research has shown that health care use is associated with mental health status, there is less information on the extent to which a mother's mental health impacts her children's health care use. Preventive pediatric health care promotes healthy development and well being via developmental, behavioral, and psychosocial assessments, as well as immunizations and other preventive services. These may be particularly important for children of mothers with a mental illness as they are at heightened risk of health and mental health problems. Applying the Andersen Behavioral Model of Health Services Use as a framework, this study examined the association between maternal mental health status and pediatric health care use in a nationally representative sample of 17,830 women parenting children ages 0-17 insured through Medicaid or SCHIP. Highlighting a need amenable to intervention, results indicated that mothers with a mental health problem were significantly more likely to experience greater levels of poverty, single parenthood, less education, fewer parenting supports and greater difficulty coping with parenting than mothers without a mental health problem. Still, they tended to access preventive and emergency department care for their children at levels comparable to mothers without a mental health problem, suggesting their resilience as caretakers. Finally, all mothers reported relatively high reliance on emergency care and suboptimal preventive care use for their school age and adolescent children, suggesting that all Medicaid- or SCHIP-insured children could benefit from targeted engagement strategies that link them with consistent and appropriate sources of pediatric health care.

Learning Objectives:
1. Explain the extent to which maternal mental health status impacts pediatric health care receipt among Medicaid and SCHIP insured children. 2. Articulate the factors that are associated with pediatric health care use among Medicaid and SCHIP insured children. 3. Discuss potential interventions to enhance preventive health care use and decrease reliance on emergency care for Medicaid and SCHIP insured families, with a focus on children whose mothers have a mental illness.

Keywords: Mental Health, Child Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student researching the impact of maternal mental health on child health and health care outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.