Table 3. Prevalence of Health Care, Family, and Community Indicators Among Children Aged 3–17 Years, Overall and by MBDD Status, National Survey of Children’s Health, 2016–2021.
| Variable | 2016–2021, % (95% CI) | 2016, % (95% CI) | 2017, % (95% CI) | 2018, % (95% CI) | 2019, % (95% CI) | 2020, % (95% CI) | 2021, % (95% CI) | Average Annual % Change, (95% CI) | P valuea | |
|---|---|---|---|---|---|---|---|---|---|---|
| Health care and receipt of services | ||||||||||
| Lacked preventive medical care, last 12 monthsc | Total | 23.1 (22.6 to 23.6) | 19.3 (18.4 to 20.3) | 19.6 (18.2 to 21.0) | —b | 17.9 (16.8 to 19.0) | 23.8 (22.8 to 24.9) | 27.1 (26.0 to 28.1) | 7.2 (−1.1 to 16.2) | .07 |
| MBDD | 18.2 (17.3 to 19.0) | 15.3 (13.7 to 17.0) | 15.8 (13.2 to 18.6) | —b | 13.6 (12.0 to 15.4) | 17.0 (15.4 to 18.8) | 20.9 (19.1 to 22.9) | 5.8 (−5.0 to 17.8) | .20 | |
| MEB | 17.6 (16.7 to 18.5) | 15.1 (13.3 to 17.2) | 15.4 (12.5 to 18.7) | —b | 13.5 (11.6 to 15.5) | 16.4 (14.5 to 18.4) | 19.4 (17.5 to 21.5) | 4.8 (−4.4 to 14.8) | .21 | |
| DLLD | 17.4 (16.3 to 18.5) | 15.3 (13.0 to 17.7) | 14.3 (11.1 to 18.1) | —b | 12.0 (10.1 to 14.2) | 17.2 (15.0 to 19.6) | 20.6 (18.2 to 23.1) | 6.5 (−7.9 to 23.2) | .26 | |
| No MBDD | 24.9 (24.3 to 25.5) | 20.7 (19.6 to 21.9) | 20.8 (19.3 to 22.5) | —b | 19.5 (18.1 to 20.9) | 26.4 (25.1 to 27.7) | 29.4 (28.1 to 30.7) | 7.4 (−1.2 to 16.8) | .07 | |
| Unmet health care needs, last 12 monthsd | Total | 3.7 (3.5 to 4.0) | 3.3 (2.9 to 3.8) | 3.6 (2.9 to 4.4) | 3.5 (3.0 to 4.0) | 3.4 (2.8 to 3.9) | 4.5 (3.9 to 5.2) | 4.1 (3.7 to 4.6) | 5.0 (0.3 to 1.0) | .04 |
| MBDD | 8.1 (7.5 to 8.7) | 7.4 (6.4 to 8.5) | 7.1 (5.4 to 9.0) | 7.4 (6.2 to 8.7) | 8.5 (6.9 to 10.4) | 9.1 (7.8 to 10.7) | 8.9 (7.8 to 10.1) | 4.7 (1.6 to 7.9) | .01 | |
| MEB | 9.3 (8.7 to 10.0) | 8.3 (7.1 to 9.6) | 7.9 (6.2 to 9.8) | 8.3 (6.9 to 9.8) | 10.2 (8.1 to 12.6) | 10.7 (9.0 to 12.6) | 10.4 (9.0 to 11.9) | 5.9 (1.7 to 10.2) | .02 | |
| DLLD | 8.4 (7.6 to 9.2) | 7.8 (6.3 to 9.5) | 8.2 (5.7 to 11.3) | 8.8 (7.0 to 10.9) | 8.5 (6.3 to 11.1) | 9.1 (7.3 to 11.0) | 7.9 (6.7 to 9.2) | 0.3 (−4.0 to 4.9) | .84 | |
| No MBDD | 2.2 (1.9 to 2.4) | 1.9 (1.5 to 2.4) | 2.4 (1.7 to 3.3) | 2.1 (1.6 to 2.6) | 1.5 (1.2 to 1.9) | 2.8 (2.2 to 3.5) | 2.3 (1.8 to 2.8) | 4.3 (−7.9 to 18.1) | .40 | |
| Health insurance adequacye | Total | 26.7 (26.2 to 27.1) | 25.5 (24.6 to 26.4) | 27.0 (25.7 to 28.3) | 27.0 (25.9 to 28.1) | 28.5 (27.3 to 29.8) | 26.7 (25.7 to 27.8) | 25.3 (24.4 to 26.3) | 0.0 (−3.1 to 3.2) | .997 |
| MBDD | 31.8 (30.9 to 32.7) | 29.2 (27.5 to 31.1) | 32.3 (29.6 to 35.1) | 32.2 (30.0 to 34.4) | 34.4 (32.1 to 36.7) | 31.7 (29.8 to 33.6) | 30.9 (29.1 to 32.7) | 0.9 (−2.7 to 4.7) | .54 | |
| MEB | 33.5 (32.5 to 34.5) | 30.4 (28.3 to 32.5) | 33.0 (30.0 to 36.2) | 34.4 (31.9 to 37.1) | 36.4 (33.6 to 39.2) | 33.6 (31.4 to 35.9) | 33.0 (30.9 to 35.1) | 1.6 (−2.1 to 5.4) | .31 | |
| DLLD | 31.1 (29.9 to 32.3) | 27.9 (25.6 to 30.4) | 33.1 (29.3 to 37.1) | 32.7 (29.7 to 35.7) | 33.6 (30.6 to 36.8) | 29.9 (27.5 to 32.4) | 29.3 (26.9 to 31.7) | 0.1 (−5.2 to 5.7) | .95 | |
| No MBDD | 24.8 (24.3 to 25.3) | 24.2 (23.1 to 25.2) | 25.1 (23.6 to 26.7) | 25.1 (23.8 to 26.4) | 26.4 (25.0 to 27.9) | 24.9 (23.7 to 26.1) | 23.1 (22.0 to 24.3) | −0.3 (−3.3 to 2.7) | .79 | |
| Received mental and/or developmental services, last 12 monthsf | Total | 18.9 (18.5 to 19.2) | 18.0 (17.3 to 18.8) | 17.7 (16.6 to 18.9) | 18.0 (17.1 to 18.9) | 19.2 (18.2 to 20.2) | 20.0 (19.1 to 20.9) | 20.3 (19.4 to 21.1) | 2.8 (1.4 to 4.2) | .005 |
| MBDD | 60.0 (59.1 to 60.9) | 58.8 (56.7 to 60.8) | 57.3 (54.3 to 60.2) | 59.0 (56.6 to 61.3) | 62.3 (60.0 to 64.5) | 61.5 (59.5 to 63.5) | 60.9 (58.9 to 62.9) | 1.1 (−0.3 to 2.5) | .10 | |
| MEB | 62.0 (60.9 to 63.1) | 61.3 (59.0 to 63.6) | 58.3 (54.9 to 61.7) | 59.9 (57.2 to 62.6) | 65.3 (62.7 to 67.9) | 63.8 (61.5 to 66.1) | 62.8 (60.6 to 65.1) | 1.1 (−1.1 to 3.3) | .25 | |
| DLLD | 69.1 (67.9 to 70.3) | 67.6 (64.8 to 70.3) | 68.9 (65.1 to 72.5) | 68.7 (65.8 to 71.6) | 70.2 (67.1 to 73.1) | 71.1 (68.6 to 73.5) | 68.2 (65.5 to 70.8) | 0.5 (−0.9 to 1.8) | .39 | |
| No MBDD | 4.1 (3.9 to 4.4) | 4.2 (3.7 to 4.7) | 4.2 (3.6 to 4.8) | 3.2 (2.8 to 3.7) | 3.9 (3.5 to 4.4) | 4.6 (4.1 to 5.2) | 4.7 (4.1 to 5.3) | 3.4 (−6.4 to 14.3) | .40 | |
| Received special education or intervention services, last 12 monthsg | Total | 9.8 (9.5 to 10.1) | 8.9 (8.4 to 9.5) | 9.6 (8.7 to 10.6) | 9.6 (8.9 to 10.4) | 9.7 (9.0 to 10.4) | 10.6 (9.9 to 11.3) | 10.4 (9.7 to 11.1) | 3.3 (1.5 to 5.2) | .007 |
| MBDD | 33.3 (32.4 to 34.2) | 31.3 (29.5 to 33.2) | 33.6 (30.7 to 36.6) | 33.8 (31.5 to 36.1) | 33.9 (31.6 to 36.2) | 34.6 (32.6 to 36.7) | 32.6 (30.8 to 34.5) | 1.0 (−1.4 to 3.4) | .32 | |
| MEB | 30.2 (29.2 to 31.2) | 28.3 (26.2 to 30.3) | 30.2 (27.0 to 33.4) | 28.9 (26.7 to 31.2) | 32.1 (29.4 to 34.8) | 32.7 (30.4 to 35.2) | 28.9 (26.9 to 30.9) | 1.3 (−2.7 to 5.5) | .42 | |
| DLLD | 51.7 (50.4 to 53.0) | 48.9 (46.1 to 51.8) | 51.9 (47.8 to 56.0) | 53.3 (50.1 to 56.4) | 52.0 (48.7 to 55.3) | 52.7 (49.9 to 55.6) | 51.2 (48.4 to 53.9) | 0.8 (−1.2 to 2.8) | .33 | |
| No MBDD | 1.4 (1.3 to 1.5) | 1.4 (1.1 to 1.7) | 1.3 (1.0 to 1.8) | 1.0 (0.7 to 1.3) | 1.2 (0.9 to 1.4) | 1.7 (1.4 to 2.1) | 1.8 (1.4 to 2.4) | 8.6 (−7.3 to 27.3) | .22 | |
| Parent and family well-being | ||||||||||
| ≥1 parent with fair/poor mental healthh | Total | 8.1 (7.8 to 8.4) | 7.6 (7.0 to 8.2) | 7.6 (6.8 to 8.6) | 7.1 (6.4 to 7.8) | 7.9 (7.1 to 8.7) | 8.8 (8.1 to 9.5) | 9.6 (8.9 to 10.3) | 5.4 (1.0 to 10.0) | .03 |
| MBDD | 14.7 (14.0 to 15.5) | 13.4 (12.0 to 15.0) | 14.9 (12.7 to 17.3) | 12.9 (11.2 to 14.7) | 14.1 (12.2 to 16.2) | 15.9 (14.2 to 17.6) | 16.8 (15.3 to 18.5) | 4.5 (0.6 to 8.6) | .03 | |
| MEB | 16.3 (15.4 to 17.1) | 15.6 (13.8 to 17.5) | 16.8 (14.2 to 19.5) | 14.0 (12.3 to 15.8) | 15.5 (13.1 to 18.0) | 17.5 (15.5 to 19.7) | 18.0 (16.3 to 19.8) | 3.1 (−1.9 to 8.4) | .16 | |
| DLLD | 14.3 (13.3 to 15.3) | 12.0 (10.3 to 13.9) | 14.2 (11.2 to 17.7) | 13.4 (10.9 to 16.2) | 13.7 (11.5 to 16.2) | 15.0 (13.0 to 17.2) | 17.0 (15.0 to 19.2) | 6.4 (3.1 to 9.9) | .006 | |
| No MBDD | 5.7 (5.4 to 6.0) | 5.6 (5.0 to 6.2) | 5.1 (4.3 to 6.1) | 5.0 (4.4 to 5.6) | 5.6 (4.9 to 6.4) | 6.2 (5.5 to 6.9) | 6.7 (6.1 to 7.5) | 4.7 (−0.4 to 10.0) | .06 | |
| Household economic stress, lifetimei | Total | 14.2 (13.7 to 14.7) | —b | —b | 15.7 (14.7 to 16.7) | 15.8 (14.8 to 16.9) | 13.1 (12.3 to 14.0) | 12.2 (11.4 to 13.1) | −9.0 (−18.5 to 1.6) | .07 |
| MBDD | 21.6 (20.6 to 22.6) | —b | —b | 23.7 (21.6 to 25.9) | 24.5 (22.3 to 26.9) | 20.9 (19.0 to 22.9) | 17.6 (16.0 to 19.2) | −10.0 (−22.1 to 4.1) | .09 | |
| MEB | 22.9 (21.8 to 24.1) | —b | —b | 24.6 (22.4 to 26.8) | 26.5 (23.8 to 29.3) | 22.3 (20.0 to 24.6) | 18.7 (16.9 to 20.6) | −9.1 (−23.7 to 8.3) | .14 | |
| DLLD | 23.6 (22.2 to 25.0) | —b | —b | 26.1 (23.1 to 29.4) | 27.5 (24.3 to 30.9) | 22.3 (19.8 to 25.0) | 18.7 (16.5 to 21.0) | −11.5 (−25.7 to 5.6) | .10 | |
| No MBDD | 11.5 (11.0 to 12.0) | —b | —b | 12.8 (11.6 to 14.0) | 12.8 (11.6 to 14.0) | 10.2 (9.4 to 11.2) | 10.2 (9.2 to 11.1) | −8.7 (−20.5 to 4.9) | .11 | |
| Community support and safety | ||||||||||
| Lacking neighborhood supportj | Total | 44.0 (43.5 to 44.5) | 45.5 (44.4 to 46.7) | 42.6 (41.0 to 44.2) | 43.5 (42.2 to 44.8) | 45.5 (44.2 to 46.9) | 43.9 (42.7 to 45.1) | 42.9 (41.7 to 44.0) | −0.7 (−2.4 to 1.1) | .34 |
| MBDD | 49.7 (48.8 to 50.7) | 52.4 (50.3 to 54.4) | 48.5 (45.5 to 51.5) | 50.2 (47.8 to 52.6) | 50.1 (47.7 to 52.5) | 49.5 (47.4 to 51.6) | 48.0 (45.9 to 50.0) | −1.3 (−2.7 to 0.0) | .05 | |
| MEB | 50.6 (49.5 to 51.6) | 52.7 (50.4 to 55.1) | 49.6 (46.2 to 53.0) | 51.6 (48.9 to 54.3) | 50.1 (47.3 to 52.9) | 50.8 (48.4 to 53.2) | 48.7 (46.3 to 51.0) | −1.2 (−2.5 to 0.1) | .07 | |
| DLLD | 51.1 (49.8 to 52.4) | 52.9 (50.1 to 55.8) | 50.2 (46.1 to 54.3) | 49.8 (46.5 to 53.0) | 53.5 (50.3 to 56.7) | 51.1 (48.4 to 53.9) | 49.2 (46.4 to 52.0) | −0.9 (−3.0 to 1.2) | .31 | |
| No MBDD | 41.9 (41.3 to 42.6) | 43.2 (41.9 to 44.5) | 40.6 (38.7 to 42.5) | 41.1 (39.5 to 42.7) | 43.9 (42.3 to 45.6) | 41.8 (40.4 to 43.2) | 4.9 (39.5 to 42.2) | −0.5 (−2.6 to 1.5) | .51 | |
| Lacking perceived neighborhood safetyk | Total | 5.3 (5.0 to 5.6) | 6.1 (5.4 to 6.8) | 4.9 (4.2 to 5.7) | 4.7 (4.1 to 5.5) | 5.4 (4.7 to 6.1) | 5.6 (5.0 to 6.3) | 5.0 (4.4 to 5.6) | −2.2 (−8.2 to 4.3) | .39 |
| MBDD | 7.1 (6.6 to 7.8) | 7.7 (6.3 to 9.3) | 7.3 (5.6 to 9.3) | 5.7 (4.6 to 7.0) | 8.5 (6.9 to 10.4) | 7.8 (6.4 to 9.4) | 5.8 (4.7 to 7.1) | −2.4 (−12.9 to 9.3) | .58 | |
| MEB | 7.5 (6.9 to 8.3) | 8.1 (6.6 to 10.0) | 7.2 (5.6 to 9.0) | 6.8 (5.4 to 8.5) | 9.1 (7.1 to 11.5) | 8.1 (6.5 to 10.0) | 6.0 (4.8 to 7.4) | −2.4 (−11.4 to 7.5) | .53 | |
| DLLD | 7.8 (7.0 to 8.7) | 7.5 (5.8 to 9.7) | 8.0 (5.5 to 11.2) | 5.8 (4.5 to 7.4) | 10.2 (7.9 to 13.0) | 8.8 (6.8 to 11.1) | 6.7 (5.1 to 8.6) | 1.5 (−13.5 to 19.1) | .81 | |
| No MBDD | 4.6 (4.3 to 4.9) | 5.5 (4.8 to 6.4) | 4.1 (3.3 to 4.9) | 4.4 (3.6 to 5.3) | 4.2 (3.5 to 5.1) | 4.8 (4.1 to 5.6) | 4.7 (4.0 to 5.5) | −1.9 (−8.9 to 5.7) | .52 | |
Abbreviations: DLLD, developmental, learning, and language disorders; MBDD, mental, behavioral, and developmental disorder; MEB, mental, emotional, and behavioral conditions.
a
Calculated by linear trend test. Significant at P < .05.
b
Data suppressed because wording of this question for these years differed substantially.
c
The child did not see a health care professional for sick-child care, well-child check-ups, physical exams, hospitalizations, or any other kind of medical care, during the past 12 months.
d
The child did not receive needed health care, during the past 12 months.
e
The child had no health insurance or the child’s health insurance coverage was inadequate to meet the child’s needs, during the past 12 months.
f
The child received mental and/or developmental services, during the past 12 months.
g
The child received services through a special education or early intervention plan. This group is a subset of those children who received any mental and/or developmental services during the last 12 months.
h
Parent (both parents if 2 primary caregivers) reported fair/poor (vs good/very good/excellent) mental health.
i
Parent reported that it was that it was difficult to get by on the family’s income somewhat/very often (vs. never/rarely).
j
Parent reported response of “definitely disagree/somewhat disagree” (vs. somewhat/definitely agree) when asked whether people in the neighborhood help each other out, watch out for each other’s children, and know where to go for help in their community when they encounter difficulties.
k
Parent reported response of “definitely disagree/somewhat disagree” (vs somewhat/definitely agree) when asked whether the child is safe in their neighborhood.