Indicators of Unmet Health Care Needs by Child-, Parent-, Household-, and County-Level Characteristics
| Characteristica | Overall Sample | Forgone Care, No. (%) or Median (IQR)b | Forgone Vaccinations or Well-Child Visits, No. (%) or Median (IQR)b | No Well-Child or Vaccine-Related Visit, No. (%) or Median (IQR)b | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Yes | No | P Value’ | Yes | No | P Valuec | Yes | No | P Valuec | ||
| Total children | 1,287 | 214 (16.3) | 1,068 (83.7) | … | 134 (10.9) | 1,148 (89.1) | … | 382 (30.1) | 900 (69.9) | … |
| Child level | ||||||||||
| Age group | .29 | .27 | .07 | |||||||
| 5-8 years | 557 (43.1) | 93 (14.9) | 461 (85.1) | 60 (9.6) | 494 (90.4) | 154 (26.9) | 398 (73.1) | |||
| 9-12 years | 729 (56.9) | 121 (17.5) | 606 (82.5) | 74 (11.9) | 653 (88.1) | 228 (32.7) | 501 (67.3) | |||
| Sex | .19 | .86 | .58 | |||||||
| Male | 672 (50.6) | 118 (18.0) | 551 (82.0) | 71 (11.1) | 598 (88.9) | 205 (30.8) | 464 (69.2) | |||
| Female | 613 (49.4) | 95 (14.6) | 516 (85.4) | 62 (10.7) | 549 (89.3) | 176 (29.3) | 435 (70.7) | |||
| Race/ethnicity | .05 | .006 | .81 | |||||||
| Non-Hispanic White | 795 (52.1) | 108 (13.2) | 685 (86.8) | 63 (8.0) | 730 (92.0) | 236 (30.6) | 556 (69.4) | |||
| Non-Hispanic Black | 129 (10.3) | 22 (14.8) | 106 (85.2) | 13 (8.7) | 115 (91.3) | 39 (32.1) | 88 (67.9) | |||
| Hispanic | 202 (26.3) | 46 (21.0) | 155 (79.0) | 30 (14.3) | 171 (85.7) | 60 (29.6) | 142 (70.4) | |||
| Non-Hispanic other race or multiracial | 153 (11.3) | 37 (21.6) | 116 (78.4) | 28 (19.0) | 125 (81.0) | 45 (26.3) | 108 (73.7) | |||
| Existing emotional, mental, developmental, behavioral condition | <.001 | .05 | .004 | |||||||
| Yes | 274 (21.8) | 80 (28.0) | 193 (72.0) | 41 (15.3) | 232 (84.7) | 60 (21.2) | 213 (78.8) | |||
| No | 1,008 (78.2) | 132 (13.0) | 873 (87.0) | 92 (9.7) | 913 (90.3) | 320 (32.5) | 684 (67.5) | |||
| Existing physical condition | <.001 | .02 | .01 | |||||||
| Yes | 154 (11.3) | 56 (34.4) | 98 (65.6) | 29 (17.5) | 125 (82.5) | 34 (19.6) | 119 (80.4) | |||
| No | 1,126 (88.7) | 156 (13.9) | 966 (86.1) | 104 (10.0) | 1,018 (90.0) | 347 (31.5) | 775 (68.5) | |||
| Child covered by health insurance | .47 | .25 | .06 | |||||||
| Yes | 1,217 (94.6) | 204 (16.7) | 1,010 (83.3) | NRd | 1,085 (88.7) | 347 (28.7) | 867 (71.3) | |||
| No | 60 (5.4) | 10 (12.9) | 49 (87.1) | NRd | 54 (93.5) | 30 (48.7) | 29 (51.3) | |||
| Experienced racism | <.001 | .001 | .92 | |||||||
| Yes | 80 (6.2) | 30 (43.3) | 50 (56.7) | 16 (25.2) | 64 (74.8) | 24 (30.8) | 55 (69.2) | |||
| No | 1,203 (93.8) | 183 (14.5) | 1,017 (85.5) | 118 (10.0) | 1,082 (90.0) | 358 (30.1) | 842 (69.9) | |||
| Mode of school instruction | .03 | .03 | .04 | |||||||
| In-person full time or hybride | 697 (51.7) | 100 (13.1) | 596 (86.9) | 60 (8.2) | 636 (91.8) | 201 (30.2) | 494 (69.8) | |||
| Virtual full time | 457 (39.7) | 87 (19.4) | 367 (80.6) | 56 (13.2) | 398 (86.8) | 129 (27.3) | 326 (72.7) | |||
| Other | 129 (8.5) | 27 (21.8) | 102 (78.2) | 18 (16.5) | 111 (83.5) | 52 (43.2) | 77 (56.8) | |||
| Parentf or household level | ||||||||||
| Age group | .12 | .37 | .39 | |||||||
| 18-29 years | 84 (8.8) | 22 (24.4) | 61 (75.6) | NRd | 70 (85.5) | 24 (24.3) | 57 (75.7) | |||
| 30-44 years | 904 (68.1) | 144 (14.6) | 756 (85.4) | 92 (9.6) | 808 (90.4) | 271 (29.9) | 631 (70.1) | |||
| 45-59 years | 258 (21.4) | 40 (17.6) | 218 (82.4) | 25 (13.5) | 233 (86.5) | 77 (33.9) | 181 (66.1) | |||
| ≥60 years | 41 (1.7) | 8 (27.8) | 33 (72.2) | NRd | 37 (86.5) | 10 (20.0) | 31 (80.0) | |||
| Sex | .17 | .99 | .31 | |||||||
| Male | 429 (44.6) | 58 (14.5) | 370 (85.5) | 40 (10.9) | 388 (89.1) | 137 (31.7) | 290 (68.3) | |||
| Female | 858 (55.4) | 156 (17.8) | 698 (82.2) | 94 (10.9) | 760 (89.1) | 245 (28.9) | 610 (71.1) | |||
| Race/ethnicity | .16 | .04 | .37 | |||||||
| Non-Hispanic White | 886 (55.2) | 126 (13.8) | 758 (86.2) | 78 (8.6) | 806 (91.4) | 268 (32.5) | 616 (67.5) | |||
| Non-Hispanic Black | 128 (11.3) | 23 (16.2) | 104 (83.8) | 14 (9.0) | 113 (91.0) | 38 (31.9) | 88 (68.1) | |||
| Hispanic | 145 (23.1) | 33 (20.2) | 111 (79.8) | 19 (14.1) | 125 (85.9) | 37 (25.3) | 107 (74.7) | |||
| Non-Hispanic other race or multiracial | 128 (10.4) | 32 (21.3) | 95 (78.7) | 23 (18.2) | 104 (81.8) | 39 (26.1) | 89 (73.9) | |||
| Racial discrimination: frequency-based codingg | 5.0 (5.0-9.0) | 7.0 (5.0-12.0) | 5.0 (5.0-7.0) | <.001 | 8.0 (5.0-11.0) | 5.0 (5.0-8.0) | <.001 | 5.0 (5.0-9.0) | 5.0 (5.0-8.0) | .34 |
| Racial discrimination: situation-based codingh | 0.0 (0.0-3.0) | 2.0 (0.0-5.0) | 0.0 (0.0-2.0) | <.001 | 2.0 (0.0-5.0) | 0.0 (0.0-2.0) | <.001 | 0.0 (0.0-3.0) | 0.0 (0.0-2.7) | .29 |
| Experienced childcare challenges | <.001 | .009 | <.001 | |||||||
| Often/sometimes | 418 (31.2) | 107 (24.4) | 309 (75.6) | 69 (15.3) | 347 (84.7) | 104 (23.3) | 312 (76.7) | |||
| Rarely/never | 867 (68.8) | 107 (12.7) | 757 (87.3) | 65 (8.9) | 799 (91.1) | 278 (33.3) | 586 (66.7) | |||
| Household income | .29 | .57 | .10 | |||||||
| <$30,000 | 239 (23.2) | 51 (17.8) | 187 (82.2) | 29 (10.1) | 209 (89.9) | 78 (30.1) | 159 (69.9) | |||
| $30,000 to <$60,000 | 327 (27.3) | 63 (19.4) | 261 (80.6) | 38 (13.3) | 286 (86.7) | 102 (33.0) | 224 (67.0) | |||
| $60,000 to <$100,000 | 366 (23.3) | 47 (13.0) | 319 (87.0) | 27 (8.7) | 339 (91.3) | 124 (33.7) | 241 (66.3) | |||
| >$100,000 | 355 (26.1) | 53 (14.8) | 301 (85.2) | 40 (11.2) | 314 (88.8) | 78 (23.9) | 276 (76.1) | |||
| County level | ||||||||||
| Ratio of population to primary care physicians | 1,375.4 (1,079.0-1,943.4) | 1,374.6 (1,111.6-1,909.5) | 1,375.4 (1,078.9-1,943.3) | .83 | 1,354.7 (1,084.7-1,946.8) | 1,377.3 (1,079.0-1,939.3) | .95 | 1,437.3 (1,144.9-2,059.5) | 1,354.3 (1,049.0-1,877.4) | .007 |
| Urban-rural classification | .27 | .08 | .002 | |||||||
| Urban | 406 (33.0) | 74 (17.2) | 330 (82.8) | 44 (11.8) | 360 (88.2) | 117 (32.0) | 288 (68.0) | |||
| Suburban | 581 (44.6) | 95 (17.4) | 483 (82.6) | 65 (12.4) | 513 (87.6) | 1 52 (23.6) | 428 (76.4) | |||
| Rural | 300 (22.4) | 45 (12.9) | 255 (87.1) | 25 (6.6) | 275 (93.4) | 113 (40.2) | 184 (59.8) | |||
| Residential segregation – Black:White index | 52.3 (45.3-62.3) | 50.9 (44.4-58.7) | 52.3 (45.4-62.7) | .28 | 53.1 (45.3-58.7) | 52.3 (45.2-62.4) | .87 | 52.3 (44.5-64.0) | 52.3 (45.4-60.4) | .92 |
| Percent of people younger than age 18 years in poverty | 15.6 (10.8-20.1) | 16.3 (10.9-19.9) | 15.4 (10.8-20.1) | .70 | 16.0 (10.8-18.5) | 15.6 (10.9-20.1) | .35 | 15.8 (10.9-20.5) | 15.6 (10.7-19.9) | .37 |
| Percent of children younger than age 19 years without health insurance | 4.6 (3.5-7.1) | 4.5 (3.4-7.1) | 4.7 (3.5-7.1) | .36 | 4.4 (3.4-6.5) | 4.7 (3.5-7.2) | .25 | 4.6 (3.5-7.1) | 4.6 (3.5-7.2) | .70 |
| Percent of inpatient beds occupied | 72.0 (60.0-80.0) | 72.5 (64.0-79.0) | 72.0 (60.0-80.0) | .68 | 74.0 (66.6-79.0) | 72.0 (60.0-80.0) | .21 | 70.0 (57.0-79.0) | 73.0 (61.0-80.0) | .05 |
IQR = interquartile range; NR = not reported.
↵a See Supplemental Table 1 for details regarding measures, survey questions, data sources, and operationalization for characteristics.
↵b Unweighted numbers and weighted percents for categorical characteristics, and medians and interquartile ranges for continuous characteristics.
↵c P values from χ2 tests with Rao and Scott second-order correction for categorical characteristics and from Wilcoxon rank-sum tests for continuous characteristics.
↵d Suppressed because the unweighted count was ≤5, which could lead to disclosure risks. Accompanying cells are also suppressed to prevent back calculations.
↵e Combination of in-person part time and virtual part time.
↵f For the parent who completed the survey.
↵g Possible range of scores is 5-20. Higher scores represent a higher frequency of racial discrimination experienced.
↵h Possible range of scores is 0-5. Higher scores represent a greater number of different situations of racial discrimination experienced.
Note: See Table 1 for indicator definitions.