Abstract
To date, life course research in maternal and child health has largely focused on elucidating fetal and early life influences on adult health and less on promoting the health of children with special health care needs (CSHCN). Consideration of life course theory (LCT) for CSHCN is especially important given their increasing prevalence and comorbidity, their disproportionate vulnerability to weaknesses or instability in the health care system, and the growing evidence linking child and adult health and quality of life. In this commentary we seek to advance the consideration of LCT for CSHCN. We (1) briefly summarize key issues and the importance of a life course approach for CSHCN; (2) present illustrative findings from population-based cross-sectional data that serve to generate hypotheses that can be more rigorously examined when population-based longitudinal data become available; and (3) discuss the application of life course principles as a driving force in the continued implementation and improvement of integrated systems of care for CSHCN.
Notes
The “Adverse Child and Family Experiences Among US Children” measure referenced here is summarized in the “Overview of Adverse Events in Childhood” data brief [20]. ACEs assess include serious financial hardship; divorce; racial discrimination; incarceration of parent; witness violence in the home; victim of violence; alcohol or substance abuse in the home; parent with mental health problems.
Based on an analysis of data from the 2008 Medical Expenditures Panel Survey (MEPS) by the authors. A standard two-part model was used to estimate health expenditures controlling for child’s age, sex, race, US geographic region, and family income.
Abbreviations
- LCT:
-
Life course theory
- CSHCN:
-
Children with special health care needs
- NSCH:
-
National Survey of Children’s Health
- NS-CSHCN:
-
National Survey of Children with Special Health Care Needs
- EBD:
-
Emotional, behavioral or development problems
- MCHB:
-
Maternal and Child Health Bureau
- SDBS:
-
Standardized developmental and behavioral screening
- DBS:
-
Developmental, behavioral and/or social
- IFSP:
-
Individualized Family Services Plan
- IEP:
-
Individualized Education Plan
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Bethell, C.D., Newacheck, P.W., Fine, A. et al. Optimizing Health and Health Care Systems for Children with Special Health Care Needs Using the Life Course Perspective. Matern Child Health J 18, 467–477 (2014). https://doi.org/10.1007/s10995-013-1371-1
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DOI: https://doi.org/10.1007/s10995-013-1371-1