title: Disability as a "family affair": parental disability and childhood immunization.
abstract: BACKGROUND
  There is a substantial body of research focusing on the health and healthcare utilization of individuals with a disability but less has been done to examine the impact of disability on nondisabled family members.
  
  
  OBJECTIVE
  We sought to investigate the influence of parental disability on children's healthcare as measured by the timely receipt of childhood immunizations.
  
  
  METHODS
  Observations on 11,997 children between the ages 2 and 5 years were obtained from the 1994 and 1995 United States National Health Interview Surveys representing 27,534,841 children when weighted. Children are determined to be in compliance with the Centers for Disease Control immunization protocol at age 24 months if they have received 4 DTP, 3 polio, and 1 MMR vaccine dose. Disability is characterized using the activity and personal care scales from the National Health Interview Surveys. The data were analyzed using logistic regression controlling for factors identified in prior research to be related to timely receipt of immunization.
  
  
  RESULTS
  Children living with a parent who is unable to provide his or her own personal care are 65% less likely (odds ratio = 0.35; 95% confidence interval = 0.17-0.70) to be immunized on time than children who live with parent(s) who do not have a disability. Children of parents who are limited in their personal care, and children of parents who have work limitations, are not less likely than children of nondisabled parents to receive immunizations on time.
  
  
  CONCLUSIONS
  The impact of a parent's severe disability extends to the health care of dependent children. These findings argue for research to investigate the full scope of the effects of parental disability on children's health and for policies that address this impact.
authors.affiliation: John Hancock Center for Physical Activity and Nutrition, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts 02111, USA. raymond.hyatt@tufts.edu
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Hyatt
authors.forename: Susan M
authors.initials: SM
authors.lastname: Allen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002662:Child Health Services / Q000592:standards / Q000706:statistics & numerical data*; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage*; D004185:Disability Evaluation; D005192:Family Health; D005843:Geography; D019538:Health Care Surveys; D006801:Humans; D007115:Immunization Schedule; D019458:Insurance Coverage; D016015:Logistic Models; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D008875:Middle Aged; D010290:Parents; D017410:Practice Guidelines as Topic; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022542:Measles-Mumps-Rubella Vaccine