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More kids are getting wellness checkups, but big gaps remain





For decades, pediatricians have recommended a regular schedule of child health visits – to check on children’s growth, development and health, and to provide parents with the opportunity to speak with their children’s doctors, catch up on children about scheduled vaccinations and more.

Now, a JAMA Pediatrics study sheds light on both the growth and the inequality in healthy child visits. Recordings are associated with better health outcomes, fewer hospitalizations and emergency room visits, and better communication between provider and parents.

Health and social care researchers at the Agency for Healthcare Research and Quality analyzed data from more than 36,500 children documented in the Medical Expenditure Panel Survey, an ongoing national survey of people who use health care in the United States. To find out if visitation compliance had increased, they compared data from 2006 and 2007 to 2016 and 2017.

Researchers found that 14.5% more children had the recommended checkups in 2016 and 2017, which increased the number of compliant children from 47.9% to 62.3%.

But this growth was far from equal. When the researchers dove into the data, they found that non-white children trailed their counterparts in healthy child visits. About 68% of non-Hispanic white children were compliant in 2016 and 2017, compared to 52.5% of black children and 58% of Hispanic children.

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Not surprisingly, insured status mattered. Although membership levels increased more for children covered by public insurance and children without insurance coverage, only 31% of uninsured children made the recommended visits in 2016 and 2017.

While 67.6% of children whose parents had attended college made it to their health check, around 50% of children whose parents did not complete high school were not checked in time.

There were also regional variations: some 79.3% of children in the Northeast made the recommended visits, but only 65.3% of children in the Midwest, 58.2% in the South, and 55.2% in the West did the same.

To correct the imbalance, the researchers write, policymakers and health professionals must work to improve both access and professional engagement in marginalized communities.

Although researchers are still struggling to understand why parents skip health visits, factors such as work, transportation and patient education are thought to play a role.