LOS ANGELES -- In 2002, approximately 15.0% of children (or approximately 400,000 children) in the county had special health care needs (SHCNs), according to findings from the Los Angeles County Health Survey. This is comparable to national estimates of 13%-16%. The survey found marked disparities in the percentage of children with SHCNs across different racial/ethnic groups and geographic areas. The highest rates were reported among African-American children (25.4%) and children in the West (23.4%) and Antelope Valley (22.6%) Service Planning Areas (SPAs).
This group of children with SHCNs encompasses an extremely diverse group including those with chronic conditions such as asthma or diabetes, developmental disabilities such as cerebral palsy, autism, and mental illnesses. This group has or is at increased risk for chronic medical, developmental, behavioral, or emotional needs. Subsequently, they may require a greater amount and complexity of services than are needed by most other children.
Based on the responses of the parents interviewed, the percentage of children with SHCNs was higher among children living in households with incomes above 300% of the federal poverty level (FPL) (19.7%) than among children in lower income households (13.7%). Additionally, among Latino and Asian/Pacific Islander children, the rates were higher among those living in more affluent households.
“This suggests that children in families with lower incomes may be at increased risk of having unrecognized needs, because there is no reason to believe lower income families are less likely to have a special needs child.” said Jonathan Fielding, M.D., M.P.H., Director of Public Health and County Health Officer. “Children with SHCNs represent an important vulnerable and underserved population, and continued community efforts are also needed to increase early detection of this population. Early detection and intervention is most beneficial before children reach school-age to help maximize child health and development, as well as improve long-term outcomes of certain disabilities.”
The survey also found that nearly all these children were reported by their parents to have health insurance (93.1%) and a regular source of health care (95.0%). However, despite the high percentage with insurance coverage and a regular source of care, 21.1% of parents of children with SHCNs reported difficulty getting medical care for their child when they needed it. Furthermore, their parents were more likely than other parents to report language barriers (29.3% vs. 14.2%) and transportation barriers (13.4% vs. 6.0%) in trying to get their child needed services.
“All children with SHCNs should have a “medical home,” including a designated pediatrician or other primary health care provider who can work effectively with parents,” said Dr. Fielding. “Medical homes with well- integrated, community-based systems of care will help to ensure that the child’s medical, developmental, and psychosocial needs are met.” For a copy of the complete study, visit: http://lapublichealth.org/ha.
Health survey background The Los Angeles County Health Survey is a periodic, population-based telephone survey that collects information on socio-demographic characteristics, health status, health behaviors and access to health services among adults and children in the County. The 2002-03 survey collected information on a random sample of more than 8,000 adults and nearly 6,000 children with interviews offered in six languages.
Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control and community and family health and comprises more than 4,000 employees with an annual budget exceeding $600 million.