Online Program

Infant health care utilization: Role of social isolation and mobility

Wednesday, November 6, 2013 : 9:10 a.m. - 9:30 a.m.

Patrick Vivier, MD, PhD, Public Health Program and Department of Pediatrics, Brown University, Providence, RI
Michelle Rogers, PhD, Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI
Miles Ott, Public Health Program, Brown University, Providence, RI
Melissa Clark, PhD, School of Public Health-Department of Epidemiology, Brown University, Providence, RI
The first year of life is a time of high utilization of health services. The purpose of our study was to better understand factors associated with infant healthcare utilization using a prospective birth cohort in Rhode Island. All women with a live birth were recruited from Women and Infants Hospital in early 2009. Participation involved an in-person structured postpartum interview at the time of consent and two follow-up phone interviews at 7 and 13 months postpartum (n=740 mothers completed the 13-month interview). We examined several measures of infant healthcare utilization and explored the impact of social isolation and mobility while controlling for family characteristics, provider type, and insurance coverage. Thirteen percent of the mothers were classified as socially isolated; 29% reported moving between birth and the child's first birthday. Mobility was positively associated with sick visits (but not well visits). Those who moved had more sick visits on average than those who did not move (Incidence Rate Ratio=1.19, 95% CI=1.03-1.39). Nearly 40% of the mothers reported they would seek advice from their pediatrician first (chosen from a list of potential advice givers) if their child were sick. Socially isolated mothers were more likely to endorse seeking health advice from their pediatrician first (OR=2.16, 95% CI=1.30-3.59). Mobility and social isolation are significantly associated with infant healthcare utilization and can have important implications for providers and public health planning. Screening families for mobility and social isolation may be an important tool, as these are risk factors associated with higher utilization.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify family and provider characteristics that may affect infant health service utilization. Assess the effect of maternal social isolation and geographic mobility on infant health care utilization.

Keyword(s): Health Care Utilization, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a pediatrician and doctorally-trained health services researcher. I am the director of the MPH program at Brown University.
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.