Abstract
Objectives
To characterize the health and health care experiences of children in the U.S. Virgin Islands (USVI), assess differences by household poverty status, and provide comparisons to the general U.S. child population.
Methods
Data are from the 2011–2012 National Survey of Children’s Health, which included 2342 USVI children, aged 0–17 years. Parent-reported measures of health status and health conditions, behavioral characteristics, and health care access and utilization were assessed. Weighted prevalence estimates were calculated and compared by household poverty status using Chi square tests.
Results
Overall, 31.3% of USVI children lived in households below 100% of the federal poverty level (FPL). Children in these low-income households were more likely to have public insurance (33.0% vs. 8.4%) and unmet health needs (11.6% vs. 6.3%) as compared to those in households with incomes ≥ 100% FPL (all p < 0.01). They were also less likely to have a medical home (22.5% vs. 42.2%), including a usual source of sick care (p < 0.01). Compared with U.S. children in general, USVI children had lower rates of preventive medical visits, preventive dental visits, and care received in a medical home.
Conclusions
USVI children experience challenges in accessing and utilizing health care services, particularly those in low-income households, and fare worse than U.S. children on many of these measures. These findings will serve as a baseline comparison for an upcoming survey of maternal and child health to be conducted in eight U.S. territories including the USVI.
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References
Adebanjo, T., Godfred-Cato, S., Viens, L., Fischer, M., Staples, J. E., Kuhnert-Tallman, W., et al. (2017). Update: Interim guidance for the diagnosis, evaluation, and management of infants with possible congenital zika virus infection—United States, October 2017. Morbidity and Mortality Weekly Report, 66(41), 1089–1099. https://doi.org/10.15585/mmwr.mm6641a1.
Artiga, S., Hall, C., Rudowitz, R., & Lyons, B. (2018, April). Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms. Retrieved June 19, 2019, from http://files.kff.org/attachment/Issue-Brief-Health-Care-in-Puerto-Rico-and-the-US-Virgin-Islands-A-Six-Month-Check-Up-After-the-Storms.
Austin, D. (2018, June 20). Economic and Fiscal Conditions in the U.S. Virgin Islands. (Congressional Research Service Report R45235). Retrieved June 19, 2019, from https://fas.org/sgp/crs/row/R45235.pdf.
Blumberg, S. J., Foster, E. B., Frasier, A. M., Satorius, J., Skalland, B. J., Nysse-Carris, K. L., et al. (2012). Design and operation of the National Survey of Children’s Health, 2007. Vital Health Statistics, 1(55), 1–149.
Bramlett, M. D., Blumberg, S. J., Zablotsky, B., George, J. M., Ormson, A. E., Frasier, A. M., et al. (2017). Design and operation of the National survey of children’s health, 2011–2012. Vital Health Statistics, 1(59), 1–256.
Bramlett, M. D., Read, D., Bethell, C., & Blumberg, S. J. (2009). Differentiating subgroups of children with special health care needs by health status and complexity of health care needs. Maternal and Child Health Journal, 13, 151–163.
Centers for Disease Control and Prevention. (2017). Community Assessment for Public Health Emergency Response (CASPER): U.S. Virgin Islands. Retrieved June 19, 2019, from https://www.cdc.gov/nceh/hsb/disaster/casper/states/USV.htm.
Centers for Disease Control and Prevention, National Center for Health Statistics. 2011–2012 National Survey of Children’s Health: Questionnaire (English). Retrieved June 19, 2019, from https://www.cdc.gov/nchs/data/slaits/2011NSCHQuestionnaire.pdf.
Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases. National Immunization Survey. Retrieved June 19, 2019, from https://www.cdc.gov/vaccines/imz-managers/nis/index.html.
Central Intelligence Agency. (2018). The World Factbook. Retrieved May 14, 2019, from https://www.cia.gov/library/publications/the-world-factbook/geos/vq.html.
Community Foundation of the Virgin Islands. (2016). KIDS COUNT USVI Data Book 2015, By the Numbers: Where Do We Stand? Retrieved May 31, 2018, from https://cfvi.files.wordpress.com/2016/12/2015-data-book-revised-12-7-16.pdf.
Dziuban, E. J., Peacock, G., & Frogel, M. (2017). A child’s health is the public’s health: Progress and gaps in addressing pediatric needs in public health emergencies. American Journal of Public Health, 107(S2), S134–s137. https://doi.org/10.2105/ajph.2017.303950.
Garza, J. R., Pérez, E. A., Prelip, M., McCarthy, W. J., Feldman, J. M., et al. (2011). Occurrence and correlates of overweight and obesity among island Puerto Rican youth. Ethnicity and Disease, 21(2), 163–169.
Greer, M. H., Larson, K., & Sison, S. (2003). Comparative analysis of oral health indicators among young children in Hawai’i, the Republic of Palau and Territory of Guam, 1999–2000. Pacific Health Dialog, 10(1), 6–11.
Ikejezie, J., Shapiro, C. N., Kim, J., Chiu, M., Almiron, M., Ugarte, C., et al. (2017). Zika virus transmission—Region of the Americas, May 15, 2015–December 15, 2016. Morbidity and Mortality Weekly Report, 66(12), 329–334. https://doi.org/10.15585/mmwr.mm6612a4.
Langellier, B. A., Martin, M. A., Canino, G., Carza, J. R., & Ortega, A. N. (2012). The health status of youth in Puerto Rico. Clinical Pediatrics, 51(6), 569–573.
Maternal and Child Health Services Title V Block Grant Virgin Islands. FY 2016 Application/FY 2014 Annual Report. (2016, March 16). Retrieved June 19, 2019, from https://mchb.tvisdata.hrsa.gov/uploadedfiles/StateSubmittedFiles/2016/VI/VI_TitleV_PrintVersion.pdf.
Maternal and Child Health Services Title V Block Grant Virgin Islands. FY 2018 Application/FY 2016 Annual Report. (2017, October 2). Retrieved June 19, 2019, from https://mchb.tvisdata.hrsa.gov/uploadedfiles/StateSubmittedFiles/2018/VI/VI_TitleV_PrintVersion.pdf.
National Heart Lung and Blood Institute. (2011). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics, 128(Suppl 5), S213–256. https://doi.org/10.1542/peds.2009-2107c.
Population Reference Bureau. (2002, November 26). Children in the U.S. Virgin Islands. Retrieved June 19, 2019, from https://www.prb.org/childrenintheusvirginislands/.
Strasburger, V. C. (2011). Children, adolescents, obesity, and the media. Pediatrics, 128(1), 201–208. https://doi.org/10.1542/peds.2011-1066.
U.S. Department of Commerce, Bureau of the Census. (2018). Current Population Survey, 2018 Annual Social and Economic Supplement. Retrieved June 19, 2019, from https://www.census.gov/programs-surveys/cps.html.
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. (2011). The 2011 HHS Poverty Guidelines. Retrieved June 19, 2019, from https://aspe.hhs.gov/2011-hhs-poverty-guidelines.
U.S. Department of Homeland Security, Federal Emergency Management Agency. (2017, October 20). Progress Underway in U.S. Virgin Islands Recovery after Back-to-Back Hurricanes. (FEMA Release Number: NR 023). Retrieved June 19, 2019, from https://www.fema.gov/news-release/2017/10/20/progress-underway-us-virgin-islands-recovery-after-back-back-hurricanes.
Washington, R. E., Orchard, T. J., Arena, V. C., Laporte, R. E., & Tull, E. S. (2013). Incidence of type 1 and type 2 diabetes in youth in the US Virgin Islands, 2001–2010. Pediatric Diabetes, 14(4), 280–287.
Wise, P. H., & Meyers, Al. (1988). Poverty and child health. Pediatric Clinics of North America, 35(6), 1169–1186.
Acknowledgements
The authors would like to acknowledge Kathleen Greenaway and Charmaine Mayers from the U.S. Virgin Islands Department of Health for their assistance with conceptualizing the study.
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The views expressed in this publication are solely the opinions of the authors and do not necessarily reflect the official policies of the U.S. Department of Health and Human Services and the Health Resources and Services Administration, nor does mention of the department or agency names imply endorsement by the U.S. Government.
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Vladutiu, C.J., Lebrun-Harris, L.A., Carlos, M.P. et al. Assessing Child Health and Health Care in the U.S. Virgin Islands Using the National Survey of Children’s Health. Matern Child Health J 23, 1271–1280 (2019). https://doi.org/10.1007/s10995-019-02767-8
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DOI: https://doi.org/10.1007/s10995-019-02767-8