Maternal and Child Health Journal

, Volume 18, Issue 9, pp 2071–2079

Chronic Conditions, Functional Difficulties, and Disease Burden Among American Indian/Alaska Native Children with Special Health Care Needs, 2009–2010

Authors

    • US Department of Health and Human Services, Health Resources and Services AdministrationMaternal and Child Health Bureau
  • Judy Thierry
    • US Department of Health and Human Services, Health Resources and Services AdministrationMaternal and Child Health Bureau
Article

DOI: 10.1007/s10995-014-1454-7

Cite this article as:
Kenney, M.K. & Thierry, J. Matern Child Health J (2014) 18: 2071. doi:10.1007/s10995-014-1454-7

Abstract

The purpose of this study was to determine the prevalence of chronic conditions and functional difficulties of American Indian/Alaska Native (AIAN) children with special health care needs (CSHCN). We conducted bivariate and multivariable analysis of cross-sectional data on 40,202 children from the 2009–2010 National Survey of Children with Special Health Care Needs aged birth through 17 years, including 1,051 AIAN CSHCN. The prevalence of AIAN CSHCN was 15.7 %, not significantly different from the prevalence of US white CSHCN (16.3 %). As qualifiers for special needs status among AIAN children the use of or need for prescription medication was the most frequent (70 %), compared to the lower rates of need for elevated service use (44 %) and emotional, mental, or behavioral treatment/counseling (36 %). Asthma (45 %), conduct disorder (18 %), developmental delay (27 %), and migraine headaches (16 %) were significantly more common chronic conditions among AIAN CSHCN compared to white CSHCN, as were functional difficulties with respiration (52 %), communication (42 %), anxiety/depression (57 %), and behavior (54 %). AIAN CSHCN were also more likely to have 3 or more chronic conditions (39 vs. 28 %, respectively) and 3 or more functional difficulties (70 vs. 55 %, respectively) than white CSHCN. Results indicated a greater impact on the daily activities of AIAN CSHCN compared to white CSHCN (74 vs. 63 %). Significantly greater disease burden among AIAN CSHCN suggests that care must be taken to ensure an appropriate level of coordinated care in a medical home to ameliorate the severity and complexity of their conditions.

Keywords

American Indian and Alaska NativeChildren with special health care needsChronic conditionsFunctional difficultiesRacial disparities

Copyright information

© Springer Science+Business Media New York (outside the USA) 2014