Missed and Delayed Preventive Health Care Visits Among US Children Due to the COVID-19 Pandemic

Abstract

Objective: The COVID-19 pandemic led to a substantial drop in US children’s preventive care, which had not fully rebounded by the end of 2020. We sought to estimate the overall prevalence of missed, skipped, or delayed preventive checkups among households with children in the last 12 months because of the pandemic. Methods: We used data from the US Census Bureau’s Household Pulse Survey, Phase 3.1 (collected April–May 2021). The analytic sample included 48 824 households with ≥1 child or adolescent aged <18 years. We estimated both national and state-level prevalences, examined associations with sociodemographic and household characteristics, and described reasons for missed or delayed preventive visits. Results: Overall, 26.4% (95% CI, 25.5%-27.2%) of households reported that ≥1 child or adolescent had missed or delayed a preventive visit because of COVID-19; percentages varied by state, from 17.9% in Wyoming to 37.0% in Vermont. The prevalence of missed or delayed preventive visits was significantly higher among respondents who reported material hardships (ie, not caught up on rent/mortgage, difficulty paying usual household expenses, children not eating enough because of lack of affordability) than among respondents who did not report material hardships. The most common reasons for missing or delaying preventive visits were concern about visiting a health care provider, limited appointment availability, and the provider’s location being closed. Conclusions: Programs and policies could reduce gaps in children’s preventive care caused by the pandemic, with a particular focus on addressing social determinants of health.

Five-Year Trends in US Children’s Health and Well-being, 2016-2020

“…Other federal data have shown that 18% of households with children reported child care disruptions more than 1 year after the onset of the pandemic; among those households, 1 in 4 adults cut their work hours or took unpaid leave to care for children and 1 in 6 left a job or did not look for a job so they could care for children. 14 Taken together, these findings highlight a critical need to support both children and their caregivers to improve families' mental and emotional well-being and to provide child care options that can ensure families' economic well-being. Study findings also confirm previous reports that children's health care use dropped after the pandemic's onset.…”

“…Other sources indicate that the most common reasons for missed or delayed preventive visits included limited appointment availability, health care locations being closed, and caregiver concerns about visiting health care professionals. 15 Efforts are needed to help families make up lost ground with respect to forgone health care during the pandemic.…”

“…In addition to the direct effects of the pandemic on pediatric populations (infection, hospitalization, and deaths), 10 the indirect effects have been pervasive, ranging from family economic hardships to reduced physical activity and increased screen time. [11][12][13][14][15] The recent release of the 2020 National Survey of Children's Health (NSCH) offers an opportunity to examine 5-year trends in children's well-being, including an exploration of potential effects of the COVID-19 pandemic. The purpose of this study was to assess changes over time in several domains: children's health conditions, positive health behaviors, access to and utilization of health care services, and family well-being and stressors.…”

The Association between Types of COVID-19 Information Source and the Avoidance of Child Health Checkups in Japan: Findings from the JACSIS 2021 Study

“…The coronavirus disease 2019 (COVID-19) pandemic has impaired children’s well-being not only through the direct health consequences of viral infection, but also through reduced access to health checkups [ 7 , 8 ]. A previous retrospective study of 935 children who underwent neonatal hip ultrasonography during the COVID-19 pandemic in Turkey reported that the number of late diagnoses of developmental dysplasia of the hip, a congenital condition that should be detected through child health checkups, has increased due to fewer parents applying for checkups [ 9 ].…”

Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic

“…Disruptions in school and alterations in socialization contributed to worsening child mental health ( Cutler et al, 2022 ; Howard-Jones et al, 2021; Shankar et al, 2022 ). There were also changes in utilization of pediatric primary care, including decreased use of preventative care and receipt of routine vaccinations ( Lebrun-Harris et al, 2022 ; Schweiberger et al, 2021 ). These changes culminated in significant increases in unmet pediatric healthcare needs.…”