Neighborhood safety and delays in health care among children with special health care needs

Research shows that residents of disadvantaged neighborhoods are less likely to have access to healthcare and are more likely to experience unmet needs. However, there is limited research into the effects of neighborhood characteristics on the group of children with special healthcare needs (CSHCN) as it relates to delays in care. CSHCN, defined as children who are at increased risk for a chronic condition and who require health services beyond that required by children generally, are a vulnerable population. The current study explores the association between neighborhood safety and delays in healthcare among CSHCN.

Data from the 2007 National Survey of Children's Health (NSCH) were analyzed using weighted procedures to account for complex sample design. Approximately 19% of children met CSHCN criteria. The parents of CSHCN were more likely to report that they lived in unsafe neighborhoods (OR=1.17, 95% CI: 1.04, 1.32). Among CSHCN, those living in unsafe neighborhoods were at greater risk for experiencing delays in care when compared to children living in safe neighborhoods (OR=1.74, 95% CI: 1.34, 2.26). This finding remained in multivariate analysis after adjusting for poverty level and race.

Results from this study further clarify the association between neighborhood safety and access to timely health care. CSHCN living in unsafe neighborhoods experience more delays in health care, especially for White families and those with low SES. This is a critical finding because barriers to timely healthcare have been associated with increased rates of morbidity among CSHCN.