230617 Neighborhood safety and delays in health care among children with special health care needs

Monday, November 8, 2010

Falicia Gibbs, MPH , Global Health - Reproductive Health and Population Studies, Emory, Rollins School of Public Health, Atlanta, GA
Lara R. Robinson, Phd MPH , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Susanna Visser, MS , Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA
Ruth Perou, PhD , Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA
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.

Learning Areas:
Diversity and culture
Provision of health care to the public
Public health or related public policy

Learning Objectives:
1) Describe the associations between CSHCN, perceived neighborhood safety, and delays in health care. 2) Discuss the implications of neighborhood safety on CHSCN. 3) Identify one potential strategy to mediate neighborhood condition disparities among CSHCN.

Keywords: Child Health, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I researched this information extensively and worked closely with experts to develop a sound abstract.
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.