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. Author manuscript; available in PMC: 2019 Jul 1.
Published in final edited form as: Congenit Heart Dis. 2018 Apr 6;13(4):554–562. doi: 10.1111/chd.12605

TABLE 3.

Associations between demographic characteristics and financial burdens and need for mental health services among families of children with congenital heart disease, NS-CSHCN, United States, 2009–2010

Out-of-pocket expenses >$1000
Family experienced financial problems
Family members stopped working or cut hours to care for child
Family member spends ≥11 hours/week providing or coordinating care
Family members needed mental health services due to child’s condition
Age 0-5 years
aPR (95% CI)		 Age 6-17 years
aPR (95% CI)		 Age 0-5 years
aPR (95% CI)		 Age 6-17 years
aPR (95% CI)		 Age 0-5 years
aPR (95% CI)		 Age 6-17 years
aPR (95% CI)		 Age 0-5 years
aPR (95% CI)		 Age 6-17 years
aPR (95% CI)		 Age 0-5 years
aPR (95% CI)		 Age 6-17 years
aPR (95% CI)
Child’s sex
 Female 1.3 (0.9, 1.7) 1.2 (1.0, 1.5) 0.9 (0.7, 1.3) 1.0 (0.8, 1.2) 1.1 (0.9, 1.4) 1.0 (0.8, 1.2) 1.0 (0.7, 1.4) 0.8 (0.6, 1.1) 1.5 (0.9, 2.4) 1.4 (1.0, 2.1)
 Male 1 1 1 1 1 1 1 1 1 1
Child’s race/ethnicity
 White, Non-Hispanic 1 1 1 1 1 1 1 1 1 1
 Black, Non-Hispanic 0.8 (0.3, 2.4) 0.7 (0.4, 1.3) 1.1 (0.6, 2.0) 0.9 (0.6, 1.4) 1.2 (0.7, 1.9) 0.9 (0.6, 1.3) 1.4 (0.9, 2.4) 1.0 (0.6, 1.6) 0.5 (0.1, 2.2) 0.7 (0.4, 1.3)
 Hispanic 0.8 (0.4, 1.6) 0.7 (0.5, 1.1) 0.7 (0.4, 1.2) 1.0 (0.7, 1.4) 0.8 (0.5, 1.2) 1.3 (1.0, 1.7) 0.8 (0.4, 1.5) 1.2 (0.8, 1.9) 1.1 (0.4, 3.3) 0.9 (0.4, 1.8)
 Othera 1.5 (0.8, 2.6) 0.9 (0.6, 1.5) 2.0 (1.4, 3.0) 1.2 (0.8, 1.8) 1.0 (0.7, 1.6) 1.2 (0.8, 1.9) 1.8 (1.1, 2.9) 1.2 (0.7, 1.9) 2.3 (1.3, 4.2) 1.4 (0.9, 2.4)
Child’s insurance type
 Any private 1 1 1 1 1 1 1 1
 Public 0.5 (0.3, 1.0) 0.5 (0.3, 0.9) 0.7 (0.5, 1.1) 0.7 (0.5, 1.0) –e –e 1.5 (0.9, 2.4) 1.5 (1.0, 2.3) 1.5 (0.8, 3.1) 0.9 (0.5, 1.7)
 Uninsured 2.0 (1.1, 3.5) 1.6 (1.0, 2.4) 1.7 (1.0, 2.8) 2.0 (1.5, 2.7) 3.0 (1.7, 5.3) 1.2 (0.5, 2.8) 5.2 (1.8,14.8) 0.9 (0.4, 2.6)
Medical homeb
 Yes 1 1 1 1 1 1 1 1 1 1
 No 0.9 (0.6, 1.3) 0.8 (0.7, 1.1) 1.8 (1.2, 2.5) 1.2 (0.9, 1.5) 1.2 (0.9, 1.5) 1.1 (0.9, 1.4) 1.4 (0.9, 2.1) 1.2 (0.8, 1.8) 1.2 (0.6, 2.2) 1.3 (0.8, 2.0)
Types of comorbiditiesc
 None 1 1 1 1 1 1 1 1 1 1
 Developmental 1.0 (0.5, 2.2) 0.8 (0.5, 1.2) 1.4 (0.7, 3.0) 0.7 (0.4, 1.1) 1.1 (0.7, 1.8) 1.1 (0.6, 1.9) 0.9 (0.3, 2.6) 1.1 (0.4, 2.7) 0.7 (0.2, 2.6) 18.3 (3.8, 87.4)
 Physical 1.5 (0.9, 2.7) 0.9 (0.6, 1.3) 2.3 (1.3, 4.3) 0.8 (0.6, 1.3) 1.0 (0.7, 1.5) 0.9 (0.5, 1.6) 1.4 (0.7, 2.7) 1.1 (0.4, 3.0) 1.6 (0.7, 3.7) 6.4 (1.2, 33.8)
 Both 1.8 (0.9, 3.3) 1.0 (0.7, 1.4) 2.5 (1.3, 4.7) 0.9 (0.6, 1.4) 1.2 (0.8, 1.8) 1.2 (0.7, 1.9) 1.6 (0.8, 3.2) 1.6 (0.7, 3.6) 1.2 (0.5, 3.3) 26.9 (5.9,123.4)f
Condition affects daily activities
 Never affected 1 1 1 1 1 1 1 1 1 1
 Moderately affect, some of the time 1.0 (0.6, 1.6) 1.1 (0.8, 1.5) 1.3 (0.8, 2.1) 1.6 (1.0, 2.4) 1.9 (1.2, 3.0) 1.6 (1.0, 2.5) 7.2 (3.1, 16.7) 3.2 (1.4, 7.0) 1.8 (0.8, 4.1) 1.8 (0.8, 4.3)
 Consistently affect, often a great deal 1.3 (0.8, 2.1) 1.3 (1.0, 1.9) 1.4 (0.9, 2.3) 2.5 (1.6, 3.8) 2.2 (1.4, 3.5) 2.5 (1.6, 4.0) 11.7 (5.1, 26.9) 8.4 (4.1, 17.0) 2.3 (0.9, 6.3) 2.0 (0.9, 4.5)
Family structure
 Two parents 1 1 1 1 1 1 1 1 1 1
 Mother only 1.1 (0.6, 2.0) 1.2 (0.9, 1.6) 0.7 (0.4, 1.2) 1.4 (1.0, 1.8) 0.9 (0.6, 1.3) 1.0 (0.8, 1.3) 0.9 (0.6, 1.5) 1.2 (0.9, 1.8) 0.8 (0.3, 2.1) 1.1 (0.7, 1.8)
 Other structures 1.5 (0.8, 2.8) 0.3 (0.1, 0.7) 1.5 (0.9, 2.4) 1.2 (0.6, 2.2) 1.5 (0.9, 2.3) 0.8 (0.5, 1.3) 1.0 (0.4, 2.8) 1.1 (0.5, 2.2) 0.8 (0.2, 3.5) 1.6 (0.8, 3.2)
Highest education of any household member
 <High school 1 1 1 1 1 1 1 1 1 1
 High school 0.3 (0.1, 1.4) 0.9 (0.5, 2.0) 1.2 (0.6, 2.6) 1.6 (0.9, 3.0) 1.0 (0.6, 1.7) 2.0 (1.1, 3.7) 2.1 (0.6, 7.2) 1.2 (0.6, 2.2) 0.2 (0.1, 0.9) 0.4 (0.2, 1.0)
 >High school 0.7 (0.2, 2.4) 1.1 (0.6, 2.1) 1.2 (0.6, 2.5) 1.9 (1.0, 3.3) 1.0 (0.6, 1.7) 2.1 (1.2, 3.8) 2.3 (0.7, 7.8) 1.2 (0.6, 2.2) 0.5 (0.2, 1.1) 0.9 (0.5, 1.8)
Federal poverty statusd
 <100% FPL 0.4 (0.2, 1.1) 0.4 (0.2, 0.8) 1.5 (0.8, 3.0) 1.7 (1.1, 2.8) 1.1 (0.7, 1.6) 1.6 (1.1, 2.2) 1.0 (0.5, 1.9) 1.5 (0.7, 2.9) 0.4 (0.2, 1.2) 1.2 (0.7, 2.3)
 100%-199% FPL 0.8 (0.4, 1.4) 0.6 (0.4, 0.9) 1.6 (0.8, 3.0) 1.4 (0.9, 2.0) 1.1 (0.8, 1.6) 1.5 (1.1, 2.1) 1.1 (0.5, 2.1) 1.5 (0.8, 2.7) 0.8 (0.3, 2.5) 1.0 (0.5, 2.0)
 200%-399% FPL 1.1 (0.8, 1.6) 0.8 (0.6, 1.0) 1.8 (1.0, 3.1) 1.6 (1.2, 2.2) 0.9 (0.7, 1.3) 1.2 (0.9, 1.6) 1.2 (0.7, 1.9) 1.2 (0.7, 2.1) 2.0 (0.9, 4.4) 0.8 (0.5, 1.4)
 ≥400% FPL 1 1 1 1 1 1 1 1 1 1
Financial problems
 Yes – – – – – – – – 1.2 (0.7, 2.2) 2.1 (1.3, 3.3)
 No 1 1

All models also adjusted for all variables in table as well as person completing the survey: mother, father, or other family member/guardian, and financial problems was added to mental health needs model. Abbreviations: aPR, adjusted prevalence ratio; CI, confidence interval; FPL, federal poverty level.

a

Other includes respondents identified as Asian, Alaskan Native, American Indian, Native Hawaiian, Pacific Islander, or mixed race.

b

Meets Maternal and Child Health Bureau criteria for a medical home.

c

Developmental comorbidities include attention deficit disorder or attention deficit hyperactivity disorder, depression, anxiety, behavioral or conduct problems, autism or an autism spectrum disorder, developmental delay, an intellectual disability or mental retardation, Down syndrome; physical comorbidities include asthma, diabetes, epilepsy or seizure disorder, migraines or frequent headaches, blood problems, cystic fibrosis, cerebral palsy, muscular dystrophy, arthritis or joint problems, allergies, and head injury, concussion or traumatic brain injury.

d

Based on US Department of Health and Human Services poverty guidelines.

e

Insurance type removed from employment impact model based on expected relationship between insurance and employment. Fifty percent of families with uninsured children had employment changes compared with 37% of children with private insurance.

f

Low numbers in cells led to wide confidence intervals that may influence precision of estimates.