Well-Child Visits
View as PDF (Best for Printing)

Headline

In 2004, children under the age of six without health insurance coverage were significantly less likely than children with health insurance coverage to have received a well-child check-up in the past year (66 percent versus 87 percent, respectively). (See Figure 1)

Importance

During a well-child visit, a pediatrician provides preventive care by assessing a child physically, behaviorally, developmentally, and emotionally. A well-child visit is a critical opportunity for a child's developmental delay or disability to be detected, which can lead to treatment, lessening the future impact on both the child and family.¹

In addition, well-child visits allow physicians to promote behaviors conducive to healthy development and give age-appropriate counseling, called anticipatory guidance.^2,3 Research shows that parents want more guidance in basic areas of childrearing, such as discipline or how to encourage learning,⁴ with one study finding that more than half (53 percent) of parents surveyed reported that they could use more guidance in at least three of six areas. Anticipatory guidance given during a well-child visit can change parenting practices, such as using time-outs instead of harsher forms of discipline⁵ and increase knowledge of injury prevention practices and infant sleep patterns.⁶ Anticipatory guidance from a physician has also been found to increase the likelihood that parents will read to a child or that the child will be breastfed.⁷

The American Academy of Pediatrics' age-specific recommendations for preventive pediatric care cover the following areas: medical history, measurement (such as height, weight, blood pressure), sensory screening (vision and hearing), developmental/behavioral assessment, physical examination, immunizations and screenings, anticipatory guidance (such as injury prevention and nutrition counseling), and dental referral.^8,9 As traditional childhood diseases become less prevalent, guidelines have become more focused on encouraging pediatricians to also address the parent/child relationship and other psychosocial aspects of development.^10,11

Trends

The percentage of children under age six who received a well-child check-up in the past year ranged from 84 percent to 85 percent between 2000 and 2004, and was at 85 percent in 2004. (See Table 1)

> Back to Top

Differences by Health Insurance Coverage

In 2004, children under the age of six without health insurance coverage were significantly less likely than children with health insurance coverage to have received a well-child check-up in the past year (66 percent versus 87 percent, respectively). (See Figure 1)

Differences by Race and Ethnicity

Hispanic children are less likely than non-Hispanic white and non-Hispanic black children to receive a well-child check up. In 2004, 77 percent of Hispanic children received a well-child check up, compared with 87 percent of non-Hispanic white children and 88 percent of non-Hispanic black children. (See Table 1)

Differences by Parental Education

In 2004, 90 percent of children whose parents have a bachelor's degree or more had received a well-child check-up in the past year, compared with 71 percent of children of parents with less than a high school degree. (See Figure 2)

Differences by Immigrant Status

Children under age six with at least one foreign-born resident parent were less likely than children with no foreign-born parent to have received a well-child check-up in the past year (78 percent versus 88 percent, respectively, in 2004). (See Table 1)

Differences by Age

Within the age groups reporting, younger children were more likely than older children to have received a well-child check-up in 2004: 88 percent of children under the age of two had received a well-child check-up, compared with 82 percent of children ages four years to five years. (See Figure 3)

Differences by Region

Children under age six living in the Northeast were the most likely to have received a well-child check-up in the past year. (See Table 1) In 2004, 91 percent of children under age six living in the Northeast had received a well-child check-up in the past year, compared with 88 percent of children living in the Midwest, 84 percent of children living in the South, and 80 percent of children living in the West.

Related Indicators

Immunization, Late or No Prenatal Care, Health Care Coverage

> Back to Top

State and Local Estimates

None available

International Estimates

None available

National Goals

The American Academy of Pediatrics (AAP) recommends that children visit their pediatrician for a well-child check-up as a newborn, by one month, at two, four, six, nine, twelve, fifteen, eighteen, and twenty-four months, and once at year from ages three to twenty-one. The APP has published "Guidelines for Health Supervision III," which contains recommendations for each well-child visit from birth to age twenty-one. This publication is available for purchase at: http://www.aap.org/bst/index.cfm?DID=15

A one-page summary of recommendations from the AAP entitled "Recommendations for Preventative Pediatric Health Care" is available to download at: http://www.aap.org/healthtopics/commped.cfm

> Back to Top

What Works: Programs and Interventions that May Influence this Indicator

None available at this time.

Research References

¹American Academy of Pediatrics, "Developmental Surveillance and Screening of Infants and Young Children,." Pediatrics 108 (1,2001): 192-195. http://pediatrics.aappublications.org/cgi/content/full/113/6/S1/1899

²American Academy of Pediatrics, "The New Morbidity Revisited: A Renewed Commitment of the Psychosocial Aspects of Pediatric Care," Pediatrics 108 (5,2001): 1227-1230. Available at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/5/1227

³M. Regalado and N. Halfon, "Primary Care Services Promoting Optimal Child Development from Birth to Age Three Years: Review of the Literature," Archives of Pediatrics and Adolescent Medicine 155 (12,2001): 1311-1312. Available at: http://www.cmwf.org/usr_doc/regalado_optimalchild_531.pdf.

⁴See Young K.T., Davis K., Schoen C., Parker S. (1998). "Listening to parents. A national survey of parents with young children ." Archives of Pediatric and Adolescent Medicine, 152(3):255-62. http://archpedi.ama-assn.org/cgi/content/abstract/152/3/255 or Schuster M.A., Duan N., Regalado M., and Klein D.J. " (2000). "Anticipatory guidance: what information do parents receive? What information do they want?" Archives of Pediatric and Adolescent Medicine, 154(12):1191-8. http://archpedi.ama-assn.org/cgi/content/abstract/154/12/1191

⁵ R.D. Sege, C. Perry, L. Stigol, et al., "Short-term Effectiveness of Anticipatory Guidance to Reduce Early Childhood Risks for Subsequent Violence," Archives of Pediatrics and Adolescent Medicine 156 (1,2002): 62-66.

⁶Child Trends and Center for Child Health Research. 2004. "Early Childhood Development in Social Context: A Chartbook." http://www.cmwf.org/publications/publications_show.htm?doc_id=237483

⁷Young K.T., Davis K., Schoen C., Parker S. (1998).

⁸American Academy of Pediatrics. (March 2000). "Recommendations for Preventative Pediatric Health Care." Pediatrics, 105(3), pp. 645-646 http://www.aap.org/healthtopics/commped.cfm

⁹Other organizations have published guidelines as well. For other examples see Green, M. and Palfrey, J.S., eds. 2002. "Bright Futures: Guidelines foe Health Supervisions of Infants, Children, and Adolescents." 2nd ed., rev. Arlington, VA: National Center for Education and Maternal Health. http://www.brightfutures.org/bf2/about.html

¹⁰Blumberg, Stephen J., Halfon, Neal, and Olson, Lynn M. (2004). "National Survey of Early Childhood Health." Pediatrics, 113(6): 1899-1906.

¹¹American Academy of Pediatrics, Committee on Psychosocial Aspects of Child and Family Health. (2001). "The New Morbidity Revisited: A Renewed Commitment to the Psychosocial Aspects of Pediatric Care." Pediatrics, 108(5): 1227-1230.http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/5/1227

> Back to Top

Definition

In the context of this indicator, a child received a well-child check-up in the past year if his or her parent answered "yes" to the question, "During the past twelve months, did {sample child} receive a well-child checkup- that is a general checkup when {he/she} was not sick or injured?"

Data Source

Child Trends' original analyses of data from the 2000-2004 National Health Interview Surveys

Raw Data Source

National Health Interview Survey
http://www.cdc.gov/nchs/nhis.htm

Approximate Date of Next Update

Winter 2006

> Back to Top