Changing Trends of Childhood Disability, 2001–2011

Abstract

BACKGROUND: Over the past half century the prevalence of childhood disability increased dramatically, coupled with notable increases in the prevalence of mental health and neurodevelopmental conditions. This study provides a detailed assessment of recent trends in childhood disability in relation to health conditions and sociodemographic factors. METHODS: Secondary data analysis of National Health Interview Survey (NHIS) datasets 2001–2002, 2004–2005, 2007–2008, and 2010–2011 (N = 198 888) was conducted to calculate the prevalence, rate of change, severity, and sociodemographic disparities of parent-reported childhood disability. RESULTS: The prevalence of childhood disability has continued to increase, growing by 15.6% between 2001–2002 and 2010–2011. Nearly 6 million children were considered disabled in 2010–2011. Children living in poverty experienced the highest rates of disability, 102.6 cases per 1000 population in 2010–2011, but unexpectedly, children living in households with incomes ≥400% above the federal poverty level experienced the largest increase (28.4%) over this 10-year period. The percentage of disability cases related to any physical health condition declined 11.8% during the decade, whereas cases related to any neurodevelopmental or mental health condition increased by 20.9%. CONCLUSIONS: Over the past decade, parent-reported childhood disability steadily increased. As childhood disability due to physical conditions declined, there was a large increase in disabilities due to neurodevelopmental or mental health problems. For the first time since the NHIS began tracking childhood disability in 1957, the rise in reported prevalence is disproportionately occurring among socially advantaged families. This unexpected finding highlights the need to better understand the social, medical, and environmental factors influencing parent reports of childhood disability.

Development of the Children With Disabilities Algorithm

“…It also enables stratification of claims-based data by CWD versus non-CWD. CWD are a distinct subset of children [7][8][9][10][11] with long-term functional impairments who have specific needs within the health care system and for whom no ICD-9-CM-based algorithm exists. CWDA contains a set of 669 ICD-9-CM codes with a $75% likelihood of indicating CWD.…”

“…[9][10][11] Many ascribe the rise in CWD prevalence to the rise in mental health-related disabilities and significant functional problems (eg, feeding impairment, learning difficulties) among those surviving with conditions previously considered untreatable (eg, extreme prematurity, congenital heart disease, HIV). 9,[12][13][14] Societal costs of CWD appear to be growing: federal spending on children in the Supplemental Security Income program, the main governmental program supporting CWD with lowincome backgrounds, has increased by 55% over the past 13 years. 15,16 Furthermore, CWD may use health care up to 8 times more frequently than their counterparts without disabilities.…”

“…CWD are a distinct subset of children [7][8][9][10][11] with long-term functional impairments stemming from a wide range of clinical diagnoses (eg, severe burns, gastrostomy dependence). CWD have specific needs within the health care system, but the quality of the care that is being delivered to this population is poorly understood.…”

Poverty and disability: What pediatric rehabilitation specialists should know about Supplemental Security Income for children with disabilities

“…Childhood disability is on the rise [1,2]. Children with disabilities are among the most vulnerable in our health care system due to their extensive health care needs and high rates of unmet need for health and related services [3].…”

“…Additionally, children with disabilities are more likely to live in poverty. Poverty is a risk factor for disability and disability is a risk factor for family poverty [2,4,5]. Pediatric rehabilitation specialists (physicians, nurses, therapists, psychologists, social workers.…”