Table 4.
Multivariate Associations Between US Child and Family Characteristics and Children’s Receipt of Preventive Counseling/Anticipatory Guidance (2002-2006)
| Demographic and Other Characteristics | Never had Counseling regarding Healthy Eatinga | Never had Counseling regarding Exercise b | No Counseling regarding Use of Safety Restraints in carsc | Never had Counseling regarding use of Bike Helmetsd | No Counseling regarding Smoking in House Being Bad for Child’s Healthe |
|---|---|---|---|---|---|
| aRR (95% CI) | aRR (95% CI) | aRR (95% CI) | aRR (95% CI) | aRR (95% CI) | |
| Child Health INS/USC (ref Yes INS/Yes USC1) | |||||
| Yes INS/No USC2 | 1.34 (1.26-1.43) | 1.13 (1.08-1.19) | 1.16 (1.10-1.23) | 1.18 (1.12-1.25) | 1.18 (1.11-1.26) |
| No INS/Yes USC3 | 1.11 (1.05-1.17) | 1.06 (1.02-1.10) | 1.06 (1.01-1.10) | 1.06 (1.02-1.11) | 1.06 (1.01-1.10) |
| No INS/No USC4 | 1.43 (1.35-1.51) | 1.24 (1.20-1.29) | 1.22 (1.16-1.29) | 1.25 (1.19-1.31) | 1.32 (1.26-1.38) |
|
| |||||
| Child’s Age (years) * (ref ≤4) | |||||
| 5-9 | 1.14 (1.10-1.19) | 0.89 (0.87-0.92) | 1.41 (1.36-1.47) | 0.82 (0.80-0.85) | 1.14 (1.10-1.19) |
| 10-13 | 1.22 (1.17-1.28) | 0.85 (0.83-0.88) | 1.59 (1.53-1.66) | 0.90 (0.87-0.94) | 1.25 (1.20-1.30) |
| 14-17 | 1.33 (1.27-1.40) | 0.88 (0.85-0.91) | 1.67 (1.59-1.75) | 1.05 (1.02-1.09) | 1.29 (1.24-1.34) |
|
| |||||
| Race/Ethnicity (ref White Not Hispanic) | |||||
| Hispanic, Any Race | 0.90 (0.85-0.95) | 0.89 (0.85-0.92) | 0.92 (0.88-0.96) | 0.99 (0.95-1.03) | 0.97 (0.92-1.02) |
| Non-White, Non-Hispanic | 0.99 (0.94-1.05) | 0.99 (0.96-1.03) | 1.03 (0.99-1.07) | 1.03 (0.99-1.07) | 0.99 (0.95-1.04) |
|
| |||||
| Parental Employment (ref Employed) | |||||
| Not Employed | 0.96 (0.90-1.02) | 0.97 (0.93-1.02) | 0.98 (0.93-1.03) | 0.97 (0.92-1.03) | 0.93 (0.88-0.99) |
|
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| Geographic Residence (ref Northeast) | |||||
| Midwest | 1.23 (1.12-1.36) | 1.17 (1.10-1.25) | 1.13 (1.04-1.22) | 1.18 (1.10-1.27) | 1.01 (0.95-1.08) |
| South | 1.20 (1.09-1.31) | 1.16 (1.10-1.22) | 1.16 (1.07-1.24) | 1.26 (1.18-1.34) | 1.01 (0.95-1.07) |
| West | 1.24 (1.13-1.36) | 1.13 (1.06-1.20) | 1.12 (1.04-1.20) | 1.16 (1.08-1.25) | 1.05 (0.98-1.12) |
|
| |||||
| Parental Education (ref At least 12 years) | |||||
| Less than 12 years | 1.11 (1.06-1.16) | 1.06 (1.03-1.09) | 1.01 (0.97-1.05) | 1.04 (1.00-1.09) | 0.90 (0.86-0.95) |
|
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| Household Income as a percent of Federal Poverty Level (FPL) (ref High Income) | |||||
| Middle Income | 1.20 (1.13-1.26) | 1.11 (1.07-1.15) | 1.06 (1.01-1.10) | 1.11 (1.06-1.16) | 0.91 (0.88-0.95) |
| Low Income | 1.25 (1.17-1.34) | 1.11 (1.06-1.15) | 1.10 (1.05-1.15) | 1.11 (1.06-1.17) | 0.85 (0.81-0.89) |
| Near Poor | 1.29 (1.19-1.41) | 1.12 (1.05-1.18) | 1.06 (1.00-1.13) | 1.11 (1.04-1.18) | 0.80 (0.74-0.87) |
| Poor | 1.21 (1.14-1.29) | 1.09 (1.04-1.14) | 1.05 (0.99-1.10) | 1.09 (1.03-1.15) | 0.76 (0.72-0.81) |
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| Family Composition (ref Linked with 2 parents in the household) | |||||
| Linked with 1 parent in the household | 1.00 (0.96-1.05) | 1.02 (1.00-1.05) | 1.04 (1.01-1.08) | 1.03 (0.99-1.07) | 0.95 (0.92-0.99) |
|
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| Child’s Health Status (ref Excellent) | |||||
| Not Excellent | 0.92 (0.89-0.95) | 0.95 (0.93-0.97) | 1.02 (0.99-1.04) | 1.02 (0.99-1.05) | 0.94 (0.91-0.96) |
|
| |||||
| Parent’s Health Insurance Status (at least 1 parent insured all year) | |||||
| No Parent Insured all year | 1.01 (0.97-1.06) | 1.00 (0.97-1.03) | 1.05 (1.01-1.09) | 1.05 (1.01-1.08) | 0.98 (0.94-1.02) |
|
| |||||
| Parent USC (ref at least one parent has a USC) | |||||
| No Parent USC | 1.05 (1.00-1.10) | 1.04 (1.01-1.08) | 1.03 (0.99-1.07) | 1.03 (0.99-1.07) | 1.03 (0.99-1.07) |
Source: 2002-2006 Medical Expenditure Panel Survey (MEPS), Household Component
aRR: adjusted risk ratio, CI: confidence interval
Note: Children with no parent record(s) linked (n=1,731) were excluded from all models because information could not be obtained for parental employment, education, insurance status, and usual source of care.
For the receipt of preventive counseling services outcomes, except second hand smoke exposure, the lowest age category includes only children ages 2-4, rather than 0-4, because these questions were only asked of children ages 2-17.
Yes Insurance All Year/Yes Usual Source of Care
Yes Insurance All Year/No Usual Source of Care
No Insurance (uninsured or partial coverage)/Yes Usual Source of Care
No Insurance (uninsured or partial coverage)/No Usual Source of Care
Respondent reported having never received advice from a doctor or health care provider regarding child’s eating healthy.
Respondent reported having never received advice from a doctor or health care provider regarding amount and kind of exercise, sports or physically active hobbies child should have.
Respondent reported having never received advice from a doctor or health care provider about using a safety seat, booster seat, or lap and shoulder belts when child rides in the car.
Respondent reported having never received advice from a doctor or health care provider about the child’s using a helmet when riding a bicycle or motorcycle.
Respondent reported having never received advice from a doctor or health care provider that smoking in the house can be bad for the child’s health.