Health care use of 3-year-old low birth weight premature children: effects of family and neighborhood poverty.
OBJECTIVE
The objective of this study was to examine the effect of family and neighborhood income on health care use of young children born prematurely and of low birth weight (N = 619).


METHODS
A birth cohort was enrolled in a clinical randomized trial of early childhood educational and family services.


METHODS
Infant Health and Development Program provided a sample of low birth weight premature infants stratified by clinical site, birth weight, and treatment group. Maternal reports of health care use, family income, and heath insurance were obtained at 12, 24, and 36 months of corrected age. Neighborhood income was based on census tract residence at birth.


METHODS
Maternal reports of hospitalizations, doctor visits, and emergency department visits were used; data were averaged over the child's first 3 years of life.


RESULTS
Children from poorer families were more likely to be hospitalized and to have more emergency department visits than were children from more affluent families. Residence in poor and middle-income neighborhoods was associated with more emergency department visits than residence in affluent neighborhoods. Families in middle-income neighborhoods reported more doctor visits than families in poor or affluent neighborhoods.


CONCLUSIONS
Neighborhood residence influences health care use by poor and nonpoor families and by insured and uninsured families. The use of the emergency department for low birth weight premature children in middle-income and poor neighborhoods is discussed.
Brooks-Gunn
J
J
Center for Children and Families, Teachers College, Columbia University, New York, NY 10027, USA.
McCormick
M C
MC
Klebanov
P K
PK
McCarton
C
C
D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D007230:Infant, Low Birth Weight / Q000254:growth & development*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data*; D011204:Poverty Areas; D012111:Residence Characteristics; D014481:United States / Q000453:epidemiology