The unmet health needs of America's children

Objective. Unmet need for health care is a critical indicator of access pro blems. Among children, unmet need for care has special significance inasmuc h as the failure to obtain treatment can affect health status and functioni ng in the near- and long-term. The purpose of this study was to present cur rent prevalence estimates and descriptive characteristics of children with unmet health needs using nationally representative household survey data. Methods. We analyzed 4 years of National Health Interview Survey data spann ing 1993 through 1996. Our analysis included 97 206 children <18 years old. Measures of unmet need for medical care, dental care, prescription medicat ions, and vision care were obtained from an adult household member (usually the mother) responding for the child. Bivariate and multivariate analyses were used to assess the degree to which unmet need was related to the demog raphic and socioeconomic characteristics of the child and family. Results. Overall, 7.3% (4.7 million) of US children experienced at least 1 unmet health care need. Dental care was the most prevalent unmet need. Afte r adjustment for confounding factors, near- poor and poor children were bot h about 3 times more likely to have an unmet need as nonpoor children (adju sted odds ratio [95% confidence interval] = 2.89 [2.52, 3.32], 3.0 [2.53, 3 .56], respectively). Uninsured children were also about 3 times more likely to have an unmet need as privately insured children (adjusted odds ratio [ 95% confidence interval] = 2.92 [2.58, 3.32]). Conclusions. Despite the nation's great wealth, unmet health needs remain p revalent among US children. A combined public policy that addresses financi al and nonfinancial barriers to care is required to reduce the prevalence o f unmet need for health care.