To examine access to healthcare and health outcomes for kindergartners as they relate to insurance status and type. For the 2008, 2009, and 2010 school years, surveys were distributed to parents with a child entering kindergarten in the state of Nevada. Surveys asked parents to provide information about their child concerning their insurance status, routine medical care, medical conditions, and health behaviors. Compared to their insured peers, uninsured kindergartners were less likely to have had a check-up in the previous 12 months (p < .001; OR 6.14; 95 % CI 5.77-6.53), have a primary physician (p < .001; OR 14.32; 95 % CI 13.49-15.20), or have seen a dentist (p < .001; OR 3.93; 95 % CI 3.70-4.16), and were more likely to have a reported unmet medical need (p < .001; OR 2.60; 95 % CI 2.19-3.07). Additionally, compared to children with private insurance, those children with public insurance were less likely to have had a check-up (p < .001; OR 1.73; 95 % CI 1.59-1.89), have a primary care provider (p < .001; OR 3.87; 95 % CI 3.55-4.21), and were more likely to have unmet medical needs (p < .001; OR 2.27; 95 % CI 1.83-2.81). For children in early development-a deeply critical period-insurance status and type are predictors of important access to healthcare variables.
The goal of the this study was to track and assess children's health status in Nevada and build relationships between researchers and school districts through the collection of mutually beneficial health data at a local level. All elementary schools in Nevada were sent a health survey for parents of kindergarten students to complete. A total of 3,628 surveys were received with usable height and weight needed to calculate Body Mass Index (BMI). African American and Hispanic children had significantly higher BMI scores compared to Caucasian and Asian/Pacific Islander children, regardless of income. Children who had diabetes or mental health concerns also had significantly higher mean BMIs compared to children without these health concerns. Overall staff within the school districts felt that this surveillance system should be continued as data from this study provided important information subsequently used to guide programming and when applying for grants. Our children's welfare depends on community collaboration to create and implement data-driven initiatives to combat childhood obesity.
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