Infant health care utilization: Role of social isolation and mobility

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.