title: Chronic conditions, functional difficulties, and disease burden among American Indian/Alaska Native children with special health care needs, 2009-2010.
abstract: The purpose of this study was to determine the prevalence of chronic conditions and functional difficulties of American Indian/Alaska Native (AIAN) children with special health care needs (CSHCN). We conducted bivariate and multivariable analysis of cross-sectional data on 40,202 children from the 2009-2010 National Survey of Children with Special Health Care Needs aged birth through 17 years, including 1,051 AIAN CSHCN. The prevalence of AIAN CSHCN was 15.7 %, not significantly different from the prevalence of US white CSHCN (16.3 %). As qualifiers for special needs status among AIAN children the use of or need for prescription medication was the most frequent (70 %), compared to the lower rates of need for elevated service use (44 %) and emotional, mental, or behavioral treatment/counseling (36 %). Asthma (45 %), conduct disorder (18 %), developmental delay (27 %), and migraine headaches (16 %) were significantly more common chronic conditions among AIAN CSHCN compared to white CSHCN, as were functional difficulties with respiration (52 %), communication (42 %), anxiety/depression (57 %), and behavior (54 %). AIAN CSHCN were also more likely to have 3 or more chronic conditions (39 vs. 28 %, respectively) and 3 or more functional difficulties (70 vs. 55 %, respectively) than white CSHCN. Results indicated a greater impact on the daily activities of AIAN CSHCN compared to white CSHCN (74 vs. 63 %). Significantly greater disease burden among AIAN CSHCN suggests that care must be taken to ensure an appropriate level of coordinated care in a medical home to ameliorate the severity and complexity of their conditions.
authors.affiliation: US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD, 20857, USA, mkenney@hrsa.gov.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Kenney
authors.forename: Judy
authors.initials: J
authors.lastname: Thierry
mesh_terms: D000293:Adolescent; D000413:Alaska / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000208:ethnology*; D002658:Developmental Disabilities / Q000208:ethnology*; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D007859:Learning Disabilities / Q000208:ethnology*; D008297:Male; D020380:Needs Assessment; D011203:Poverty / Q000706:statistics & numerical data; D015995:Prevalence