Early life adversity, use of specialist care and unmet specialist care need among children

J Child Health Care. 2019 Sep;23(3):392-402. doi: 10.1177/1367493518807830. Epub 2018 Nov 8.

Abstract

Adverse childhood experiences (ACEs) are linked to increased utilization of health care among adults; however, the impact of ACEs on nonmental health specialist care has been largely overlooked. To address this, data from the 2011-2012 National Survey of Children's Health (n = 89,357) were used to assess the health of children aged 0-17 living with a parent or guardian. Use of specialist care among children in the past 12 months was the outcome of interest and experiencing any one of nine ACEs was the independent variable of interest. After adjusting for confounders in logistic regression modeling, children who experience specific ACEs had higher odds of receiving specialist care. All ACEs were associated with higher unmet need of specialist care, and each additional ACE was independently associated with higher odds of needing specialist care among those who had not received it. This study provides evidence of that experiencing specific ACEs lead to increased demand of nonmental health specialist services among children and adds to the growing body of research indicating that individual ACE items may be differentially associated with health-care utilization or not associated with health-care utilization at all.

Keywords: Adverse childhood experiences; child health; health services research; inequalities in health; specialist care.

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Child
  • Child Health / statistics & numerical data*
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility*
  • Health Services Research
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Patient Acceptance of Health Care*
  • Socioeconomic Factors
  • Specialization* / economics
  • Surveys and Questionnaires
  • United States