It is morally wrong to make a mother choose between treatment for herself and treatment for her newborn. It is morally wrong that people should be dying of AIDS when treatment is available.
It is morally wrong that babies are still being born with HIV when we know how to prevent it. It is morally wrong that children are still growing up as AIDS orphans.
To be a partner for women and girls against violence and injustice, you do not have to be experts on human rights or gender. You do have to be committed to always asking in your daily work: 'How can I better engage women and girls to understand what they need'
A society that cuts itself off from its youth severs its lifeline; it is condemned to bleed to death.
When the history of our times is written, will we be remembered as the generation that turned our backs in a moment of global crisis or will it be recorded that we did the right thing?
No disease group is as vast and complex in scope as the noncommunicable diseases (NCDs). Incorporating social determinants such as income and education, the NCDs call for an equally massive and comprehensive response
There are 1.2 billion adolescents across the world, 9 out of 10 of these young people live in developing countries. Millions are denied their basic rights to quality education, health care, protection and exposed to abuse and exploitation.
Of all the forms of inequality, injustice in health care is the most shocking and inhumane.
“The early years in a child’s life—when the human brain is forming—represent a critically important window of opportunity to develop a child’s full potential and shape key academic, social, and cognitive skills that determine a child’s success in school and in life.”—President Barack Obama
“If art is to nourish the roots of our culture, society must set the artist free to follow his vision wherever it takes him.”—President JF Kennedy
"The true character of a society is revealed in how it treats its children. History will judge us by the difference we make in the everyday lives of children."—President Nelson Mandela

Disparities in Health Care Quality Indicators among US Children with Special Health Care Needs According to Household Language Use

Stella Yu, ScD, MPH, Sue Lin, MS, Bonnie Strickland, PhD

Abstract


Background: Lower health care utilization and less favorable health outcomes have been demonstrated in children from Non-English Primary Language households (NEPL) in previous studies. This study examines prevalence of health care quality indicators among US children with special health care needs (CSHCN) and their association with household language use.

Methods: We used data from the 2009-2010 National Survey of Children with Special Health Care Needs, restricted to an analytic sample of 40,242 children. Logistic regression models were used to examine the effects of primary household language on the attainment of the 6 health care quality indicators for CSHCN.

Results: Compared to CSHCN from English primary language households (EPL), CSHCN from NEPL households had 31% higher odds of not feeling like partners in health care decision-making. They had 67% higher odds of lacking care through a medical home and 42% higher odds of reporting inadequate health insurance. NEPL children had 32% higher odds of not receiving early and continuous screening for special health care needs. NEPL youths had 69% higher odds of not receiving services for transition to adulthood. Minority race/ethnicity, lower income and families other than two biological parents all conferred additional risks to not attaining quality indicators. Publicly insured or uninsured CSHCN were also at higher risk.

Conclusions and Global Health Implications: Our study provides compelling evidence that significant disparities exist for CSHCN by primary household language status across all health care quality indicators. Establishment of effective surveillance systems and targeting of outreach programs in both developed and developing countries may lead to improved understanding of health care needs and quality of services and reduction of health disparities for this underserved population.

Key words: Children with Special Health Care Needs • Household Language Use • Limited English Proficiency • Socioeconomic Status • Race/ethnicity • Health Care Quality

Copyright © 2015 Yu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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DOI: http://dx.doi.org/10.21106/ijma.51

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