title: Unmet needs for specialty, dental, mental, and allied health care among children with special health care needs: are there racial/ethnic disparities?
abstract: We examined racial/ethnic disparities in unmet specialty, dental, mental, and allied health care needs among children with special health care needs (CSHCN) using data on 38,866 children in the National Survey of CSHCN. Compared with White CSHCN, Black CSHCN had significantly greater unmet specialty (9.6% vs. 6.7%), dental (16% vs. 8.7%), and mental (27% vs. 17%) health care needs. Hispanic CSHCN had greater unmet dental care needs (15.8% vs. 8.7%). Black females had greater unmet mental health care needs than other groups (41% vs. 13-20%). Most disparities disappeared after multivariate adjustment. Significant risk factors for unmet health care needs included uninsurance, having no personal doctor/nurse, poverty, and condition stability and severity. Eliminating unmet specialty, dental, and mental health care needs for all CSHCN, and especially minority CSHCN, may require greater efforts to reduce poverty and increase insurance coverage among CSHCN, better mental health care assessment of Black female CSHCN, and ensuring all CSHCN have a medical home.
authors.affiliation: Center for the Advancement of Underserved Children, Department of Pediatrics and Department of Population Health, Medical College of Wisconsin (MCW), Milwaukee, WI, USA. engui@mcw.edu
authors.forename: Emmanuel M
authors.initials: EM
authors.lastname: Ngui
authors.forename: Glenn
authors.initials: G
authors.lastname: Flores
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D002648:Child; D003266:Continuity of Patient Care; D003752:Dental Health Services / Q000600:supply & distribution*; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D008297:Male; D008507:Medically Underserved Area; D008511:Medicine / Q000706:statistics & numerical data*; D008605:Mental Health Services / Q000600:supply & distribution*; D008913:Minority Groups / Q000706:statistics & numerical data*; D020380:Needs Assessment; D012307:Risk Factors; D013038:Specialization; D014481:United States; D044465:White People / Q000706:statistics & numerical data