Does Parental Report of Having a Medical Home Attenuate the Negative Association Between Unmet Basic Needs and Health for Low-Income Children?

Abstract

Background. It is unknown whether the medical home reduces the impact of adverse social determinants on low-income child health. Objective. To examine whether the medical home attenuates the association between unmet basic needs and health for low-income children. Design/Methods. Secondary data analysis of the 2011-12 NSCH restricted to <200% FPL children (n = 26 974). Multivariable logistic regression modeled child health with unmet basic needs to examine the effect modification of the medical home. Results. Low-income children with unmet needs had lower odds of “excellent/very good” health compared to children without unmet needs, regardless of the medical home [aOR = 0.78 (0.61-0.99) vs aOR = 0.77 (0.63-0.94), P = .01), respectively]. The medical home did not modify the negative association between unmet basic needs and “excellent/very good” child health ( P = .97). Conclusion. Having a medical home per parental report did not attenuate the negative relationship between unmet basic needs and lowincome child health.

Beyond income: material hardship and the health and healthcare of premature children

“…Responses were dichotomized as "excellent or very good" vs. "good, fair, or poor." [19][20][21] Emergency room visits were measured by the question: "During the past 12 months, how many times did this child visit a hospital emergency room?" Responses were dichotomized as ≥1 visits vs. no visits.…”

Transforming Well-Child Care to Meet the Needs of Families at the Intersection of Racism and Poverty

“…8 Conversely, for Black and Brown children, who, due to structural racism, are more likely to live in low-resource households and communities, with greater social needs, higher rates of maternal stress and depression, and in developmentally-disadvantaged environments, there is ample evidence that our structure of well-child care leads to unaddressed social needs, unmet maternal mental health needs, and wide racial gaps in developmental outcomes. 9,10 To cultivate long-term health and wellness of Black and Brown children, an antiracist structure for well-child care must be intentionally designed to mitigate the impacts that systemic and interpersonal racism can have on preventive care delivery. To do this, we must utilize structures that actively facilitate culturally-responsive care for families and appropriately address their preventive care needs.…”

Is medical home care adequacy associated with educational service use in children and youth with autism spectrum disorder (ASD)?

“…In the US, medical home disparities for children and youth with ASD have been attributed to providers' limited ASD knowledge and training [38] and in the setting of financial, social, linguistic, and cultural barriers of the families of children and youth with ASD [43]. Racial disparities in medical home care access have been shown for children and youth with ASD (i.e., Black, non-Hispanic, Hispanic, or identified as 'other race' (i.e., American Indian, Alaska Native, Asian, Native Hawaiian, or other Pacific Islander) compared to White, non-Hispanic children and youth with ASD [11,27].…”