Children with Special Health Care Needs
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Headline

Boys are a third more likely than girls to have special health care needs. In 2005, 16 percent of males under the age of 18 had special health care needs, compared with 12 percent of females. (See Figure 2)

Importance

Children with special health care needs includes children with a broad range of chronic health conditions from major physical or developmental disabilities to often less limiting conditions such as attention deficit disorder or asthma. Almost a quarter (22 percent) of children with special health care needs report being usually or always affected by their condition, while about four in ten are never affected in their ability to do things that other children their age do.¹ In 2000, children with special health care needs accounted for 34 percent of health care costs (including dental care costs) among all children, more than twice their share of the child population.^2,3

Almost thirty percent of parents of children with special health care needs report having to limit their work schedule or stop working in order to take care for their child.⁴ Parents working full-time may face difficulties with having enough leave benefits to care for their child when needed.⁵

The coordination of care, involving doctors, teachers, and community resources, can be challenging for parents of children with special health care needs. One-third of parents of children with special health care needs report receiving help with coordination of care or services.⁶

Trends

The percentage of children with special health care needs increased slightly between 2001 and 2005, from 13 percent to 14 percent.⁷ (See Figure 1)

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Differences by Gender

Males are more likely than females to have special health care needs. In 2005, 16 percent of males had special health care needs, compared with 12 percent of females. (See Figure 2)

Differences by Race and Ethnicity

Fifteen percent of both non-Hispanic white and non-Hispanic black children had special health care needs in 2005. Hispanic and Asian children were less likely to have special health care needs (8 percent and 6 percent, respectively). (See Table 1)

Differences by Age

Children ages 6 to 11 and 12 to 17 are about twice as likely as young children ages 0 to 5 to have special health care needs (16 and 17 percent versus 9 percent, in 2005). (See Figure 3)

Differences by Poverty Level

In 2005, the percentage of children with special health was about 15 percent for each of the three income groups. (See Table 1)

Related Indicators

None

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State and Local Estimates

The National Survey of Children with Special Health Care Needs Data Resource Center website allows users to generate their own state-level estimates from the 2001 and 2005-2006 surveys. Users can select their desired variable and subgroup break such as age, gender, or race/ethnicity to generate customized tables or figures. This data tool is available at:
http://cshcndata.org/Content/Default.aspx

The National Survey of Children with Special Health Care Needs Chartbook 2001 contains state profiles of children with special health care needs. Each profile contains the total number for that state, as well as state-level and national estimates of prevalence and other related indicators. The chartbook is available at: http://mchb.hrsa.gov/chscn/

International Estimates

None Available

National Goals

Through the Healthy People 2010 initiative, the federal government is aiming to increase the proportion of Territories and States that have service systems for children with special health care needs. The target for 2010 is for 100 percent of States and Territories to meet Title V requirements. In addition, there is a developmental goal to increase the proportion of children with special health care needs who have access to a medical home More information is available at http://www.healthypeople.gov/Document/HTML/Volume2/16MICH.htm#_Toc494699668

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What Works: Programs and Interventions that May Influence this Indicator

None available at this time

Research References

¹Child and Adolescent Health Measurement Initiative. 2005-06 National Survey of Children with Special Health Care Needs, Data Resource Center for Child and Adolescent Health website. Retrieved [12/20/07] from http://cshcndata.org/Content/Default.aspx

²Newacheck, Paul W. and Kim, Sue E. (2005). "A National Profile of Health Care Utilization and Expenditures for Children with Special Health Care Needs." Archives of Pediatric and Adolescent Medicine, 159: 10-17. Available at: http://archpedi.ama-assn.org/cgi/content/full/159/1/10

³Using the Medical Expenditures Survey, Newacheck and Kim (2005) found that 16 percent of children had special health care needs in 2000. These estimates are slightly higher than the estimates Child Trends is using from the National Survey of Children with Special Health Care Needs.

⁴Ibid.

⁵Chung, Michael et al. (2007). "Need for and Use of Family Leave Among Parents of Children With Special Health Care Needs." Pediatrics, 119(5), May 2007, p. e1047-e1055. Available at: http://pediatrics.aappublications.org/cgi/content/full/119/5/e1047

⁶Child Trends' analyses of the 2005-06 National Survey of Children with Special Health Care Needs, Data Resource Center for Child and Adolescent Health website. Retrieved [12/20/07] from http://cshcndata.org/Content/Default.aspx

⁷U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. The National Survey of Children with Special Health Care Needs Chartbook 2001. Rockville, Maryland: U.S. Department of Health and Human Services, 2004.

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Definition

Children with special health care needs are defined based on the federal Maternal and Child Health Bureau's definition. The parent is asked the following 5 questions: Does the child currently need prescription medications? Does the child need more medical care, mental health care, or educational services than his or her peers? Is the child limited in his or her ability to do things? Does the child need physical, occupational, or speech therapy? Does the child have an emotional, developmental, or behavioral problem? Each question is followed up with the parent being asked whether the condition is expected to last for 12 months or more and whether the condition is due to a medical, behavioral, or other health condition. If the answer to one (or more) of the conditions is yes and the answers to the follow up questions for that condition(s) are also yes, then the child is defined as having special health care needs.

Data Source

Child Trends' original analyses of data from the 2005 National Survey of Children with Special Health Care Needs.

Raw Data Source

National Survey of Children with Special Health Care Needs. Available at: http://www.cdc.gov/nchs/about/major/slaits/nscshcn_05_06.htm

Approximate Date of Next Update

Unknown

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