Chronic Illness in Children and Foregone Care Among Household Adults in the United States

A National Study

Bibliographic Data

ID9097495
AuthorsKoh Eun Narm (Cambridge Health Alliance, Cambridge, corresponding author), Jenny Wen (Cambridge Health Alliance, Cambridge, corresponding author), Lily Sung (Cambridge Health Alliance, Cambridge, corresponding author), Sofia Dar (Cambridge Health Alliance, Cambridge, corresponding author), Paul Kim (0000-0002-1755-6182, Cambridge Health Alliance, Cambridge, corresponding author), Brady Olson (Cambridge Health Alliance, Cambridge, corresponding author), Alix Schrager (Cambridge Health Alliance, Cambridge, corresponding author), Annie Tsay (Cambridge Health Alliance, Cambridge, corresponding author), David U Himmelstein (0000-0002-2394-4915, Cambridge Health Alliance, Cambridge, corresponding author), Steffie Woolhandler (0000-0002-8965-1058, Cambridge Health Alliance, Cambridge, corresponding author), Natalie Shure (Independent Researcher, Boston, MA), Danny Mccormick (Cambridge Health Alliance, Cambridge, corresponding author), Adam Gaffney (0000-0001-7326-0661, Cambridge Health Alliance, Cambridge, corresponding author)
Year2023
Volume61
Issue4
Pages185-191
Publication date2023-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001791
PMID36730827
OpenAlexW4318966498
LanguageEN
Citations received2
References cited28

BACKGROUND: Childhood chronic illness imposes financial burdens that may affect the entire family. OBJECTIVE: The aim was to assess whether adults living with children with 2 childhood chronic illnesses-asthma and diabetes-are more likely to forego their own medical care, and experience financial strain, relative to those living with children without these illnesses. RESEARCH DESIGN: 2009-2018 National Health Interview Survey. SUBJECTS: Adult-child dyads, consisting of one randomly sampled child and adult in each family. MEASURES: The main exposure was a diagnosis of asthma or diabetes in the child. The outcomes were delayed/foregone medical care for the adult as well as family financial strain; the authors evaluated their association with the child's illness using multivariable logistic regressions adjusted for potential confounders. RESULTS: The authors identified 93,264 adult-child dyads; 8499 included a child with asthma, and 179 a child with diabetes. Families with children with either illness had more medical bill problems, food insecurity, and medical expenses. Adults living with children with each illness reported more health care access problems. For instance, relative to other adults, those living with a child with asthma were more likely to forego/delay care (14.7% vs. 10.2%, adjusted odds ratio: 1.27; 95% CI: 1.16-1.39) and were more likely to forego medications, specialist, mental health, and dental care. Adults living with a child with diabetes were also more likely to forego/delay care (adjusted odds ratio: 1.76; 95% CI: 1.18-2.64). CONCLUSIONS: Adults living with children with chronic illnesses may sacrifice their own care because of cost concerns. Reducing out-of-pocket health care costs, improving health coverage, and expanding social supports for families with children with chronic conditions might mitigate such impacts

Asthma · Chronic condition · Confounding · Disease · Environmental health · Family medicine · Health care · Health insurance · Logistic regression · Medical Expenditure Panel Survey · National Health Interview Survey · Odds · Odds ratio · Population · Psychiatry · Adolescent and Pediatric Healthcare · Childhood Cancer Survivors' Quality of Life · Healthcare Policy and Management · Medicine · Gerontology

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