Maternal determinants of pediatric preventive care utilization among blacks and whites.
OBJECTIVE
We assessed maternal characteristics that were predictive of preventive care utilization among children 0-5 years and compared black-white differences in preventive care usage.


METHODS
We used the 1996-2000 series of public use files from the Medical Expenditure Panel Survey (MEPS). Receipt of preventive care was defined as up-to-date immunization coverage of the child and at least one dental visit during the year.


RESULTS
A total of 10,525 children were analyzed consisting of 2,090 blacks (19.9%) and 8,435 whites (80.1%). Black mothers were in general older and less educated. Black households were larger in size and contained a greater number of children. Black mothers earned, on average, much less than their white counterparts even though they tended to be more frequently employed than whites. Despite similar levels of insurance coverage for both racial groups, the overwhelming majority of white mothers were privately insured (73.2%), in contrast to only about half of blacks with private insurance coverage [54.3% (p < 0.0001)]. Overall, the level of pediatric preventive services utilization was a paltry 15.4%. Children of black mothers were significantly less likely to receive preventive care than whites (OR = 0.78; 95% CI = 0.64-0.94). Other determinants of preventive care use were maternal age, insurance coverage, education and family size. Older, educated mothers with insurance coverage and reduced family size were more likely to have their children immunized and have dental visits.


CONCLUSIONS
Maternal characteristics are important markers that indicate the risk for underutilization of pediatric preventive care. A particularly important finding with policy implication is the observation that maternal insurance coverage enhances pediatric preventive care use. Health policy planners may consider parallel insurance coverage of both the child and the mother in order to enhance receipt of preventive health services by the child.
Alio
Amina P
AP
Council on African American Affairs, 1115 U St. NW, Suite 201, Washington, DC 20009, USA. aalio@AfricanAmericanAffairs.org
Salihu
Hamisu M
HM
D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D019458:Insurance Coverage; D008297:Male; D008423:Maternal Age; D008425:Maternal Behavior; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American