Background
Methods
Study design and data source
Participants
Measures
Healthcare access
Adverse family impact
Covariates
Statistical analysis
Results
Very Low Birthweight (n = 242) | Low Birthweight and/or Preterm (n = 2205) | Other Children (n = 17,035) | p-value | |
---|---|---|---|---|
Estimated Number (%) | 302,945 (1.4%) | 293,8274 (13.3%) | 18,818,572 (85.3%) | ⏤ |
Age, years | 0.58 | |||
M (SD) | 2.3 (1.5) | 2.5 (1.4) | 2.5 (1.6) | |
Sex | 0.66 | |||
Male (n = 10,050) | 49.2% | 48.7% | 51.2% | |
Female (n = 9432) | 50.8% | 51.3% | 48.8% | |
Race & Ethnicity | < 0.001 | |||
White, non-Hispanic (n = 13,772) | 39.2% | 41.8% | 55.9% | |
Hispanic (n = 2086) | 21.7% | 31.3% | 21.4% | |
Black, non-Hispanic (n = 968) | 17.8% | 13.6% | 10.6% | |
Other race, non-Hispanic (n = 2656) | 21.3% | 13.2% | 12.2% | |
Nativity | 0.17 | |||
Parent born in the U.S. (n = 15,362) | 64.1% | 70.7% | 75.7% | |
Parent not born in the U.S. (n = 3252) | 35.9% | 29.3% | 24.3% | |
Primary Household Language | 0.09 | |||
English (n = 18,037) | 79.1% | 80.1% | 87.1% | |
Spanish or other language (n = 1343) | 20.9% | 19.9% | 12.9% | |
Highest Parent Education Level | 0.16 | |||
High school or less (n = 2154) | 29.1% | 27.5% | 22.3% | |
More than high school (n = 17,230) | 70.9% | 72.5% | 77.7% | |
Family Structure | 0.32 | |||
Two parents married (n = 15,306) | 59.7% | 65.2% | 70.8% | |
Two parents unmarried (n = 1494) | 19.7% | 11.4% | 10.5% | |
Single mother (n = 1723) | 9.6% | 14.1% | 12.2% | |
Other family structure (n = 815) | 11.1% | 9.3% | 6.5% | |
Household Income Levela | 0.021 | |||
0–99% FPL (n = 1930) | 24.2% | 25.1% | 18.7% | |
100–199% FPL (n = 2584) | 18.4% | 22.6% | 21.1% | |
200–399% FPL (n = 6301) | 29.1% | 25.9% | 28.5% | |
≥ 400% FPL (n = 8257) | 28.3% | 26.4% | 31.6% | |
Health Insurance Coverage | 0.019 | |||
Private health insurance only (n = 14,177) | 41.2% | 52.8% | 59.1% | |
Private and public health insurance (n = 703) | 8.9% | 4.2% | 4.1% | |
Public health insurance only (n = 3831) | 47.6% | 38.0% | 31.1% | |
Uninsured or unspecified insurance type (n = 679) | 2.4% | 5.0% | 5.7% | |
Region | 0.21 | |||
Northeast (n = 3376) | 20.4% | 16.1% | 16.4% | |
Midwest (n = 5136) | 17.3% | 18.1% | 22.0% | |
South (n = 5919) | 44.6% | 39.4% | 36.5% | |
West (n = 5051) | 17.7% | 26.3% | 25.0% | |
Children with Special Health Care Needs Status | < 0.001 | |||
No (n = 17,210) | 62.8% | 85.6% | 90.9% | |
Yes (n = 2272) | 37.2% | 14.4% | 9.2% | |
≥1 Current Chronic Health Condition(s) | < 0.001 | |||
No (n = 13,864) | 58.0% | 70.3% | 76.5% | |
Yes (n = 4739) | 42.0% | 29.7% | 23.5% | |
Adverse Childhood Experience(s)b | 0.16 | |||
None (n = 13,402) | 47.1% | 63.9% | 65.9% | |
1 Adverse childhood experience (n = 3706) | 43.5% | 23.6% | 23.1% | |
≥ 2 Adverse childhood experiences (n = 1683) | 9.3% | 12.4% | 11.0% | |
Family Resiliencec | 0.67 | |||
Some/none of the time 0–1 items (n = 1022) | 12.9% | 6.5% | 6.5% | |
Most of the time 2–3 items (n = 1791) | 10.1% | 11.1% | 8.8% | |
All of the time to all 4 items (n = 16,669) | 77.0% | 82.5% | 84.7% |
Very Low Birthweight | Low Birthweight and/or Preterm | Other Children | |
---|---|---|---|
Healthcare Access | |||
Adequate Health Insurance | 79.0% | 73.6% | 72.3% |
RR (95% CI) | 1.09 (0.98–1.22) | 1.02 (0.96–1.08) | 1.00 |
aRR (95% CI) | 1.05 (0.95–1.16) | 0.99 (0.93–1.05) | 1.00 |
p-value | 0.32 | 0.69 | – |
Medical Home | 42.2% | 42.6% | 51.8% |
RR (95% CI) | 0.81 (0.59–1.12) | 0.82 (0.72–0.94) | 1.00 |
aRR (95% CI) | 0.88 (0.66–1.17) | 0.91 (0.80–1.03) | 1.00 |
p-value | 0.38 | 0.14 | – |
Developmental Screening | 51.9% | 37.7% | 32.9% |
RR (95% CI) | 1.58 (1.03–2.42) | 1.15 (0.91–1.44) | 1.00 |
aRR (95% CI) | 1.49 (0.96–2.32) | 1.18 (0.96–1.44) | 1.00 |
p-value | 0.08 | 0.11 | – |
Adverse Family Impact | |||
≥ $1000 Out-of-Pocket Expenses | 13.5% | 13.2% | 12.3% |
RR (95% CI) | 1.10 (0.67–1.81) | 1.08 (0.83–1.39) | 1.00 |
aRR (95% CI) | 1.06 (0.69–1.64) | 1.20 (0.94–1.54) | 1.00 |
p-value | 0.78 | 0.15 | – |
Parent Cut-back or Stopped Work | 30.3% | 8.6% | 5.1% |
RR (95% CI) | 5.95 (3.59–9.86) | 1.68 (1.19–2.38) | 1.00 |
aRR (95% CI) | 2.91 (1.86–4.56) | 1.41 (0.98–2.02) | 1.00 |
p-value | <.001 | 0.06 | – |
Parental Aggravation | 9.3% | 4.3% | 3.1% |
RR (95% CI) | 3.02 (1.59–5.71) | 1.39 (0.93–2.10) | 1.00 |
aRR (95% CI) | 1.41 (0.83–2.39) | 1.14 (0.76–1.71) | 1.00 |
p-value | 0.20 | 0.54 | – |
Maternal Health Not Excellent | 73.7% | 76.8% | 73.5% |
RR (95% CI) | 1.00 (0.86–1.18) | 1.04 (0.98–1.11) | 1.00 |
aRR (95% CI) | 0.98 (0.83–1.15) | 1.03 (0.97–1.10) | 1.00 |
p-value | 0.80 | 0.32 | – |
Paternal Health Not Excellent | 81.5% | 72.4% | 71.0% |
RR (95% CI) | 1.15 (1.02–1.29) | 1.02 (0.95–1.10) | 1.00 |
aRR (95% CI) | 1.12 (0.99–1.28) | 1.01 (0.94–1.09) | 1.00 |
p-value | 0.08 | 0.71 | – |
Adverse Family Impact | |||||
---|---|---|---|---|---|
≥$1000 Out-of-Pocket Expenses | Parent Cut-Back or Stopped Work | Parental Aggravation | Maternal Health Not Excellent | Paternal Health Not Excellent | |
Healthcare Access | |||||
Adequate Health Insurance | |||||
RR (95% CI) | 0.21 (0.12–0.36) | 0.38 (0.22–0.66) | 0.37 (0.19–0.71) | 0.96 (0.84–1.08) | 0.97 (0.86–1.09) |
p-value | <.001 | 0.001 | 0.003 | 0.48 | 0.62 |
aRR (95% CI) | 0.25 (0.15–0.42) | 0.26 (0.16–0.44) | 0.44 (0.26–0.74) | 0.92 (0.83–1.02) | 0.95 (0.85–1.07) |
p-value | <.001 | <.001 | 0.002 | 0.13 | 0.39 |
Medical Home | |||||
RR (95% CI) | 0.48 (0.22–1.08) | 0.22 (0.09–0.55) | 0.27 (0.10–0.73) | 1.12 (0.98–1.29) | 1.13 (0.96–1.34) |
p-value | 0.08 | 0.001 | 0.010 | 0.09 | 0.14 |
aRR (95% CI) | 0.54 (0.38–0.76) | 0.34 (0.17–0.70) | 0.32 (0.17–0.60) | 1.04 (0.95–1.13) | 1.01 (0.92–1.12) |
p-value | <.001 | 0.004 | <.001 | 0.41 | 0.78 |
Developmental Screening | |||||
RR (95% CI) | 1.00 (0.48–2.09) | 2.29 (0.80–6.51) | 1.26 (0.27–5.85) | 1.08 (0.84–1.38) | 1.12 (0.88–1.43) |
p-value | 0.997 | 0.12 | 0.77 | 0.56 | 0.37 |
aRR (95% CI) | 0.66 (0.39–1.11) | 1.13 (0.52–2.43) | 0.69 (0.28–1.66) | 1.04 (0.87–1.23) | 1.20 (0.99–1.46) |
p-value | 0.12 | 0.76 | 0.40 | 0.70 | 0.056 |