School of Social Work, The University of Texas at Arlington, Arlington, Texas.
USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California.
Soc Work Public Health. 2024 Apr 2;39(3):261-275. doi: 10.1080/19371918.2024.2323137. Epub 2024 Mar 8.
Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016-2017 National Survey of Children's Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs ( = 4.51, < .001, 95% CI = 3.15-6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs ( = .69, < .01, 95% CI = .54-.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families.
尽管已有研究调查并发现了儿童期不良经历与健康和心理健康不良后果之间的关联,但缺乏研究调查儿童期不良经历与未满足的医疗保健需求之间的关联。本研究的目的是在调整医疗服务利用的倾向因素、促成因素和需求因素后,检验儿童期不良经历与未满足的医疗保健需求之间的关联。本研究的数据来自 2016-2017 年全国儿童健康调查。使用负二项回归分析了来自该调查的 46081 名儿童(51.3%为男性;平均年龄 11.5 岁)的分析样本。根据家长报告,约有 3.5%的儿童存在未满足的医疗保健需求,且样本中有一半(50%)的儿童经历过至少一种儿童期逆境。在控制其他因素后,与没有儿童期逆境的儿童相比,经历过三种或更多种儿童期逆境的儿童未满足医疗保健需求的可能性高出 4.51 倍( = 4.51, < .001,95%CI = 3.15-6.45)。与父母中有可寻求日常情感支持的人相比,父母中有可寻求日常情感支持的儿童未满足医疗保健需求的可能性降低了 31%( = .69, < .01,95%CI = .54-.89)。儿童期不良经历对未满足的医疗保健需求有不利影响。本研究的结果为进一步研究如何预防儿童期不良经历及其对家庭的影响提供了重要机会。