title: The extent of barriers and linkages to health care for head start children.
abstract: Data were gathered as part of a larger survey of 218 Head Start Programs in Region II (New York City, New York State (excluding New York City), New Jersey, Puerto Rico and U.S. Virgin Islands) in 1993-94. The general purpose of the survey was to obtain information on child health, screening practices, training needs, family health and community problems, barriers to diagnosis and treatment and the extent of linkages between Head Start programs and health and nutrition providers at the local level. In this study barriers to the care of Head Start children and their families were examined as perceived by the Health Coordinators or other health related staff of the Health Services Component of these programs. The extent of linkages with health and nutrition service providers were also examined. The most frequently reported barriers were lack of parent participation (72%), private transportation not available (67%), parents' perception of quality of care (64%), distance to provider (63%), cost of transportation (63%), lack of funding (56%), limited/inconvenient hours (56%), and health services not available in the community (55%). On average, programs reported linkages to 14.5 providers (including an average of 4 nutrition programs). More than 90% of them reported linkages with public health services, child protective services, WIC and private physicians/dentists. Finally, the extent of barriers and linkages were compared across different geographic areas. Significant barriers were identified in this study, yet the survey confirmed and validated the extensive nature of formal linkages with health and nutrition service providers at the local levels. These findings may indicate that the current levels of service availability may not be sufficient to meet the severity and diversity of health needs of this population.
authors.affiliation: Maternal and Child Health Program, Columbia University School of Public Health, New York, NY 10032, USA.
authors.forename: C
authors.initials: C
authors.lastname: Giambruno
authors.forename: C
authors.initials: C
authors.lastname: Cowell
authors.forename: R
authors.initials: R
authors.lastname: Barber-Madden
authors.forename: L
authors.initials: L
authors.lastname: Mauro-Bracken
mesh_terms: D000704:Analysis of Variance; D001294:Attitude to Health; D002662:Child Health Services / Q000458:organization & administration; D002675:Child, Preschool; D018479:Early Intervention, Educational / Q000458:organization & administration*; D005192:Family Health; D017144:Focus Groups; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007802:Language; D010290:Parents / Q000523:psychology; D014186:Transportation; D014481:United States