Trends in Health Equity Among Children in the United States, 1997–2018.

Objectives: Health equity is crucial to population health. To achieve this aim, extensive monitoring efforts beyond traditional disparities research are required. This analysis assesses trends in health equity for children from 1997 to 2018. Methods: Health equity in a given year is calculated using...

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Published in:Maternal & Child Health Journal Vol. 25; no. 12; pp. 1939 - 1960
Main Authors: Anderson, Nathaniel W., Zimmerman, Frederick J.
Format: research tables/charts Journal Article
Published: Springer Nature Dec2021
Online Access:View this record in EBSCOhost
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      dt: Dec2021
      vid: 25
      iid: 12
      pid: 237
      pub: Springer Nature
      place: New York, New York
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        10.1007/s10995-021-03253-w
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      ppf: 1939
      ppct: 21
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        atl: Trends in Health Equity Among Children in the United States, 1997–2018.
      aug:
        au:
          Anderson, Nathaniel W.
          Zimmerman, Frederick J.
        affil: Department of Health Policy and Management, University of California Los Angeles, 650 Charles E Young Dr S, 90095, Los Angeles, CA, USA
      sug:
        subj:
          Health Services Accessibility Trends
          Child Health
          Health Status Disparities
          Human
          United States
          Child
          Questionnaires
          Health Status
          Depression
          Race Factors
          Ethnic Groups
          Socioeconomic Factors
          Simulations
          Infant, Newborn
          Infant
          Child, Preschool
          Human Rights
          Child Advocacy
          Cross Sectional Studies
          Scales
          Data Analysis Software
          Descriptive Statistics
          Confidence Intervals
          Male
          Female
          Child: 6-12 years
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Male
          Female
      ab: Objectives: Health equity is crucial to population health. To achieve this aim, extensive monitoring efforts beyond traditional disparities research are required. This analysis assesses trends in health equity for children from 1997 to 2018. Methods: Health equity in a given year is calculated using a previously developed measure as the mean weighted departure of individual health from the best achievable level of health. This criterion is defined as the median health of the most socially privileged identifiable group: white, non-Latinx boys in upper-income households. Using more than 20 years of data from the National Health Interview Survey, we apply this methodology to six measures of child health: parent-reported health status, school days missed due to illness or injury in the past year, a strength and difficulties questionnaire score, emotional difficulties, a toddler mental health indicator score, and toddler depression. We separately calculate racial/ethnic and income disparities. Monte Carlo simulation is used to assess whether trends are statistically significant. Results: Health equity among children increased gradually over the past 2 decades, with five of the six measures demonstrating upward trends. Improvements in health equity are stronger among younger children (age 0–3 and 4–7). Unlike previous work examining adults, both types of disparities narrowed over the study period. Conclusions for Practice: Progress on health equity requires accountability to an objective metric. This analysis suggests some improvement over the past two decades, although these gains are under threat from potential decreases in government spending on programs affecting children and the COVID-19 pandemic.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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