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Med Care Res Rev. 2005 Apr;62(2):205-30.

How do stressful family environments relate to reported access and use of health care by low-income children?

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  • 1New York Academy of Medicine, NY, USA.


This study examines the effect of stressful family environments on children's access to and use of health care, using a sample of 9,854 low-income children from the 1999 National Survey of America's Families. Indicators of stress included aspects of family structure, economic hardship, family turbulence, and parental ill health; these were combined into a composite family stress indicator. Having health insurance was the strongest predictor of health care access and use, but stressful family environments were significantly and inversely associated with parents' having confidence in the ability of family members to obtain health care, children having health care needs met, and children having any dental care in the previous year. The authors concluded that while enrollment in health insurance may be necessary to access and use health care, it is not sufficient. Stressful family environments also appear to influence the ability of parents to obtain care for their children.

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