Healthy People 2010 Leading Health Indicators: How Children With Special Health Care Needs Fared

Abstract

Objectives. We compared estimates for children with and without special health care needs (SHCN) at 2 time periods for national health objectives related to the Healthy People 2010 leading health indicators (LHIs). Methods. Data were from the 2003 and 2007 National Surveys of Children’s Health. Seven survey items were relevant to the LHIs and available in both survey years: physical activity, obesity, household tobacco use, current insurance, personal health care provider, past-month depressive symptoms, and past-year emergency department visits. Results. In 2003 and 2007, children with SHCN fared worse than those without SHCN with respect to physical activity, obesity, household tobacco exposure, depressive symptomology, and emergency department visits, but fared better on current insurance and having a personal health care provider. Physical activity and access to a personal health care provider increased for all children, whereas the absolute disparity in personal provider access decreased 4.9%. Conclusions. Significant disparities exist for key population health indicators between children with and without SHCN. Analyses illustrated how population-based initiatives could be used to frame health challenges among vulnerable populations.

Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity

“…Previous efforts have explored what population health might mean more broadly for CSHCN, 9,12 but consensus outcomes for CMC, whose problems are simultaneously more severe and more heterogeneous than those of other CSHCN, remain elusive. 12,13 Although aspects of the outcomes applied to CSHCN are likely relevant to CMC, such as access to a medical home and adequate health insurance, they likely do not fully capture the nuances of the CMC population.…”

“…12,13 Although aspects of the outcomes applied to CSHCN are likely relevant to CMC, such as access to a medical home and adequate health insurance, they likely do not fully capture the nuances of the CMC population. Numerous outcomes have been included in research among CMC; 14 however, the validity of these measures and their applicability to the population are often unknown.…”

Children with Special Health Care Need?s Association of Passive Tobacco Smoke Exposure and Dental Caries: 2007 National Survey of Children?s Health

“…There are more than 14.1 million U.S. children who are CSHCN [2], and more than 20% of U.S. families have CSHCN [3]. Identifying children as CSHCN, rather than by having specific psychological abnormalities/physical conditions, has improved health care delivery programs [3], and has resulted in a national surveillance, the National Survey of Children's Health.…”

“…Identifying children as CSHCN, rather than by having specific psychological abnormalities/physical conditions, has improved health care delivery programs [3], and has resulted in a national surveillance, the National Survey of Children's Health. From the surveillance, it is known that CSHCN are at increased risk of depression, inactivity, and injury [2]. Additionally, tobacco smoke exposure is greater in CSHCN [2].…”

“…From the surveillance, it is known that CSHCN are at increased risk of depression, inactivity, and injury [2]. Additionally, tobacco smoke exposure is greater in CSHCN [2]. …”