Influence of childcare provider on medical care, mental health and educational service usage in early childhood

It is hypothesized that children aged 1 to 5 years who are cared for more than 10 hours per week by non-relatives are at increased odds to use more medical care, mental health or educational services compared to children who receive care from their parents at home. Methods: Data were obtained from the National Survey of Children's Health, 2011. Age, gender, race/ethnicity, and measures of poverty, family structure, and parent education were compared with health services usage in the last 12 months. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained with SAS version 9.3. Results/Discussion: After adjustment, we found that children cared for by a non-relative were at increased odds of health services usage (OR: 1.31; 95% CI: 1.09,1.58) compared to children cared for their parents at home, as were males (OR: 1.23; 95% CI: 1.11,1.37) compared to females, and children whose mother's marital status was single, with no father present (OR: 1.25; 95% CI: 1.01,1.55) compared to two-parent biological or adopted couples. We also identified that health services usage in African American and Hispanic children was less prevalent than in Caucasians. Conclusions: The data suggest that children aged 1 to 5 years who are cared for by non-relatives are at increased odds of use of medical care, mental health or educational services.