Health Services Access Across Racial/Ethnic Groups of Children in the Child Welfare System

• NCJ Number: 227388
• Journal: Child Abuse & Neglect Volume: 33 Issue: 5 Dated: May 2009 Pages: 282-292
• Author(s): Rebecca Wells; Marianne M. Hillemeier; Yu Bai; Rhonda Belue
• Date Published: May 2009
• Length: 11 pages
• Grant Number(s): R03 DA020748-01A1
• Sponsoring Agency: National Institute on Drug Abuse
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined access to health services among children of various racial/ethnic groups in the child welfare system in an effort to identify and explain any apparent disparities.

Abstract

Generally, caseworker reports of health care service delivered did not differ across racial/ethnic groups; however, Hispanic children had better reported access to vision services than non-Hispanic White children. Access to counseling was lower for non-Hispanic Black children compared with non-Hispanic White children. Caseworkers' self-reported efforts to facilitate service access did not vary by race/ethnicity for any type of health care. In the multiple regression model, both private health insurance and a lack of insurance were negatively associated with counseling access; however, a history of sexual abuse, adolescence, and greater caseworker effort to secure services were positively associated with access. Race was only slightly statistically insignificant after controlling for other factors expected to influence access. One possible reason offered for why Black children are less likely to be identified as needing counseling is that they are less likely than White children to have reports of sexual abuse, which strongly predicts counseling access. Since privately insured and uninsured children were less likely to receive needed mental health counseling than those children with public insurance, policymakers should focus on increasing the number of children enrolled in public health insurance programs. Data were obtained from the National Survey of Child and Adolescent Well-Being for 2,505 children. The multiple regression model was applied for 537 children. Measures pertained to child health services needed, access, and enabling factors. Chi-square and t tests were used to compare access across racial/ethnic groups. A logistic regression model further explored the greatest disparity identified, i.e., that between non-Hispanic Black and White children in caseworker-reported access to counseling. 3 tables and 45 references