Social Inequities in Healthcare Access Among U.S. Children With ADHD, Autism, and Co-occurring ADHD and Autism: Evidence From the 2023 to 2024 National Survey of Children's Health
Onwuameze, C. N.; Orji, G.; Bate, M. A.; Madu, V. O.; KAYA, P. B.; INALEGWU, J. E.
Show abstract
Objective: To compare healthcare access among U.S. children with attention-deficit/hyperactivity disorder (ADHD) only, autism only, and co-occurring ADHD-autism, and to identify social inequities associated with unmet care using recent nationally representative data. Methods: We analyzed combined 2023-2024 National Survey of Childrens Health data for 13,576 children aged 3-17 years with current ADHD and/or autism. Six healthcare-access outcomes were examined: forgone healthcare, unmet mental health care, no medical home, coverage gap or inadequate insurance, unmet specialist care, and unmet care coordination. Survey-weighted modified Poisson regression estimated adjusted prevalence ratios (aPRs) and 95 percent confidence intervals (CIs). Six multiply imputed poverty measures were combined using Rubins rules. Sensitivity models additionally adjusted for functional difficulty. Results: Compared with ADHD only, co-occurring ADHD-autism was associated with higher prevalence of forgone healthcare (aPR, 1.73; 95 percent CI, 1.38-2.16), no medical home (1.11; 1.02-1.20), inadequate or discontinuous insurance (1.14; 1.03-1.28), unmet specialist care (1.49; 1.14-1.94), and unmet care coordination (1.15; 1.04-1.28). Autism only was associated with unmet mental health care (1.49; 1.13-1.97) and care coordination (1.13; 1.02-1.25). Food insufficiency, housing instability, and non-supportive neighborhood conditions were consistently associated with poorer access. After adjustment for functional difficulty, associations remained for co-occurring ADHD-autism with forgone and specialist care and for autism only with unmet mental health care. Conclusions: Healthcare access inequities differed by neurodevelopmental diagnostic group and social context. Pediatric systems should strengthen care coordination, specialty and mental health access, insurance continuity, family navigation, and responses to food and housing hardship. Keywords: attention-deficit/hyperactivity disorder; autism spectrum disorder; healthcare access; health disparities; social determinants of health
Matching journals
The top 5 journals account for 50% of the predicted probability mass.
Similar papers in this journal
- Impacts of school closures on physical and mental health of children and young people: a systematic review 89%
- Clinical features and burden of post-acute sequelae of SARS-CoV-2 infection in children and adolescents: an exploratory EHR-based cohort study from the RECOVER program 88%
- The lasting effects of the pandemic: A time series analysis of first-time speech delays in kids under 5 years of age 88%
Similar papers in this journal
- Childhood coordination and survival up to six decades later: extended follow-up of participants in the National Child Development Study 90%
- Trends in Homeschooling Rates Following Elimination of Nonmedical Exemptions to Childhood Immunizations, 2012-2020 90%
- Public Preferences for Social Distancing Behaviors to Mitigate the Spread of COVID-19: A Discrete Choice Experiment 89%
Similar papers in this journal
- An AI-Based Chatbot to Support Health-Related Social Needs among Pediatric Primary Care Population: Protocol for a Pilot Randomized Controlled Trial 91%
- Linear growth trajectories in the first two years of life predict attained linear growth and stunting at the age of five years: Results from the MAL-ED multi-country birth cohort study 91%
- Investigating the effectiveness of school health services delivered by a health provider: a systematic review of systematic reviews 91%
Similar papers in this journal
- Economic evaluation of caregiver interventions for children with developmental disabilities: a scoping review 90%
- Assessing the impact of Covid-19 on Nurturing Care in Nairobi Slums: Findings from 5 rounds of cross-sectional telephone surveys 90%
- Assessing the approach to perinatal mental health screening and treatment in maternal-child health clinics in Western Kenya 89%
Similar papers in this journal
- Comparative analysis of policies and programs to support families and children during COVID-19 90%
- The effect of smaller classes on infection-related school absence: Evidence from the Project STAR randomized controlled trial 89%
- Gender disparities in access to care for time-sensitive conditions during COVID-19 pandemic in Chile 89%
"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.