The 130th Annual Meeting of APHA

Abstract #50186

Beverly Mulvihill, PhD¹, Susan Gyaben, MPH², Francis X. Mulvihill, PhD³, Anita Jackson, BA⁴, Joseph Telfair, DrPH, MSW/MPH³, Sheila Samples-Wentzel, BA³, and Cathy Caldwell⁵. (1) Department of Maternal and Child Health, School of Public Health, 320 Ryals Building, 1665 University Boulevard, Birmingham, AL 35294-0022, (205)975-7942, bmulvihi@uab.edu, (2) Civitan International Research Center, University of Alabama at Birmingham, 331 Sparks, 1530 3rd Avenue So., Birmingham, AL 35295-0017, (3) School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard Room 330, Birmingham, AL 35294-0022, (4) School of Public Health, Department of Maternal and Child Health, University of Alabama at Birmingham, 1665 University Boulevard Room 320, Birmingham, AL 35294-0022, (5) Children's Health Insurance Program, Alabama Department of Public Health, 201 Monroe Street, Montgomery, AL 36103

Introduction. Alabama began enrolling children and youth in its state-designed CHIP, ALL Kids, in October 1998. This paper examines the effects of disability status, age, and race on access to care and unmet needs.Methods. Mail survey data were collected from a random sample (n=6,200) of 26,213 first year enrollees (return rate: 60% [n=3,739]). Child’s disability status, age, race, gender, parental education, and family income were chosen to describe the sample and measures of access to care as outcome variables (Needed and Waited for Medical Care, Dental, Vision, Speciality, Prescriptions; and Usual Source of Care). Five questions identified those with special needs, i.e. disability status (n=996 [27%]). Analysis. Frequencies and cross tabulations revealed significant differences several before and after enrollment measures. Logistic regression analysis were used to examine change in reference to no change in the presence of the independent variables. Results. Compared to preschoolers, adolescents (O.R.=1.93-9.89) and school-agers (O.R.=1.38-4.92) were more likely to improve. For most outcomes, except usual source of care, CYSHCN were more likely to improve than children without special needs. Odds ratios ranged from 1.36 for needed dental care to 3.82 for specialty care. In models in which race was significant (6 of 10), white children were 25-36% less likely to experience improved care than were African American children. Implications. Almost all children in Alabama’s SCHIP are experiencing better access and fewer unmet needs, however, traditionally underserved groups such as CSHCN, African Americans, and adolescents appear to be faring even better in this program.

Learning Objectives:

• After attending this session, participants will
• Identify common barriers for CYSHCN to accessing quality health care
• Name 3 areas in which CYSHCN showed improvement after enrolling in SCHIP
• Discuss how SCHIP may be addressing some common disparities among vulnerable populations

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 307.0 kb)