POVERTY AND CHILDHOOD CHRONIC ILLNESS

Objective: To present national estimates of the prevalence and impact of chronic conditions for children from poor and nonpoor families by using data from the 1988 National Health Interview Survey. Methods: Proxy responses to a checklist of child health conditions administered for 17 110 children younger than 18 years were used. Conditions were classified as chronic if they were first noticed more than 3 months before the interview or if they were the type that would ordinarily be of extended duration, such as arthritis. Results: While nonpoor families were more likely than poor families to report chronic conditions for their children, children from poor families exhibited a higher risk of experiencing severe chronic conditions. Children with chronic conditions from poor families also experienced substantial barriers to care; they were 118% more likely to be uninsured than were children from nonpoor families and 42% more likely to lack a usual source of care. Children with chronic conditions from poor families were found to use fewer ambulatory care services but more inpatient hospital care than their nonpoor counterparts. Conclusion: Children from poor families experience chronic health problems that are inadequately addressed by our existing health care system.