Assessing unmet need for services for pediatric undernutrition. HSPH MPH Student Research Team.
Evaluation and treatment of undernourished children in Massachusetts has been provided since 1984 by the seven outpatient Growth and Nutrition (GN) Clinics administered by the Massachusetts Department of Public Health (MDPH). This study explored the potential unmet need for nutritional services among low-income, multiethnic children ages birth to 36 months presenting to an inner-city pediatric emergency department (ED). During March 1992, staff obtained weight and stature on all children under 36 months of age brought to the ED. A structured interview questionnaire obtained data on demographic characteristics, birth history, and participation in means-tested federal benefit programs and MDPH GN Clinics. Among 252 children with complete anthropometric data, 22 (8.9%) had at least one anthropometric index (weight-for-age, height-for-age, weight-for-height) below the fifth percentile. Birthweights < 2500 g were reported by 18.5% of caregivers; 58% of children with height-for-age less than the fifth percentile and 63% of those with weight-for-age less than the fifth percentile were low birthweight (LBW) (Fisher's exact test, P < .002 and P < .006, respectively). Thirteen percent of families had no health insurance, and 77.1% received Medicaid. Among 22 children with anthropometry less than the fifth percentile, one half to three quarters participated in federally funded programs including Special Supplemental Food Program for Women, Infants, and Children (WIC), Aid to Families With Dependent Children (AFDC), and Food Stamps, but only 11% had been referred to the GN Clinics. These findings suggest that federal means-tested benefit programs and MDPH GN Clinic services were underused by groups at nutritional risk.(ABSTRACT TRUNCATED AT 250 WORDS)
Peterson
K E
KE
Harvard School of Public Health (HSPH), Department of Maternal and Child Health, Boston, MA 02115, USA.
Wiecha
J L
JL
Casey
V
V
Meyers
A
A
Roos
N
N
Frank
D A
DA
D000886:Anthropometry; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000453:epidemiology* / Q000208:ethnology; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008404:Massachusetts / Q000453:epidemiology; D011159:Population Surveillance; D011632:Public Assistance; D012959:Socioeconomic Factors