Association between Adverse Childhood Experiences and Unmet Health Care Needs among Children in the United States

ABSTRACT

Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016–2017 National Survey of Children’s Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs (AOR = 4.51, p < .001, 95% CI = 3.15–6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs (AOR = .69, p < .01, 95% CI = .54–.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families.

KEYWORDS:

• Unmet health care needs
• health care service utilization
• adverse childhood experiences
• children
• national survey of children’s health

Disclosure statement

No potential conflict of interest was reported by the author(s).

Statement of Authors’ Contributions

All authors contributed significantly to the interpretation of the findings, the writing of the manuscript, and approval of the final version.

P. Baiden conceived of the initial idea, designed the study, analyzed, interpreted the findings, and wrote the first draft of the manuscript.

G. Graaf contributed to the interpretation of the data and wrote part of the discussion.

L. Okine contributed to writing the literature review and wrote part of the discussion.

C. LaBrenz contributed to the writing part of the discussion.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.