Maternal depressive symptoms in early infancy contribute to unfavorable patterns of health care seeking for children. Increased provider training for recognizing maternal depressive symptoms in office settings, more effective systems of referral, and development of partnerships between adult and pediatric providers could contribute to enhanced receipt of care among young children.
ROVIDING QUALITY PEDIATRIC care for young children involves matching the needs and expectations of families with the organizational structure and clinical practices of pediatric providers. There is growing evidence of deficiencies in the quality of health care for children, including low rates of preventive services, 1 persistent disparities in health status, 2 and lack of a usual source of care among ethnic and racial minorities and children in low-income families. 3 Specific limitations have been noted in the quality of care related to developmental and behavioral services for children in the first 3 years of life, 4-7 particularly regarding gaps between recommended and actual care received. 8,9 In a national survey, only 23% of 2017 parents of young children discussed discipline and early learning with their child's clinician, and over half Author Affiliations are listed at the end of this article.
A 30-year follow-up of 1,758 inner-city children and their mothers in the Pathways to Adulthood Study revealed significant associations in transgenerational timing of age at 1st birth between mothers and their daughters and sons. Intergenerational age patterns were associated with the children's family and personal characteristics during childhood and adolescence and self-sufficiency at age 27-33. Continuity in teenage parenthood was associated with family and personal characteristics unfavorable for optimal child development and successful adult outcomes. Delay in 1st parenthood to age 25 or older was associated with significantly greater odds of more favorable environmental and developmental characteristics and greater adult self-sufficiency. The authors concluded that age at 1st birth of both mothers and children contributes, but in subtly different ways for daughters and sons, to the children's development and adult self-sufficiency.
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