Children’s health needs require extra attention during jobless spikes
Some childhood health conditions are more likely to be exacerbated by a parent's job loss.
High unemployment has been shown to take a toll on the health of adults who lose their jobs for extended periods of time.
But what about the children of unemployed households? Which childhood health conditions are more likely to be exacerbated by a parental job loss to the point where hospitalization occurs?
Related: More employees at large companies relying on public insurance for children
That was the question posed by a diverse research team composed of healthcare and economics professors and statisticians. Their data, research model, and findings were reported in Children’s Health in October under the title, “Economy-Sensitive Conditions: Are Some Pediatric Hospitalizations Triggered By Economic Recessions?”
According to their work, the answer is “Yes. Some. But not all.”
The team analyzed data from 14 states beginning in 2002 and progressing through three-year intervals until 2014. The states (Colorado, Florida, Iowa, Kentucky, Michigan, Nebraska, New Jersey, New York, North Carolina, Oregon, Rhode Island, Utah, Vermont, and Washington) were chosen based on detailed reporting to the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project State Inpatient Databases.
The team justified the project on the basis of the lack of precedential studies of pediatric hospitalizations during times of high unemployment.
Much of what they found was not surprising. To wit:
- Increased hospitalizations for children were identified in every state during times of high unemployment. The overall mean all-cause increase was 2%.
- Children with chronic conditions such as diabetes or complex diagnoses were hospitalized more frequently during these periods. For each 1% increase in unemployment, they saw an average of a 4% diabetes mellitus hospitalization, and 2% for medical complexities.
- Pediatric hospitalizations that could be tied to poor housing conditions (poisonings, burns) increased. Increases of about 2% per each percentage increase in the jobless rate was reported.
But this research also delivered a few nuggets to ponder.
- Where earlier studies had found an increase in child abuse-related hospitalizations, this study did not confirm those earlier results.
- There was no significant increase in mental health-related hospitalizations among children in homes affected by unemployment.
- Among the states studied, Vermont and Iowa had the highest percent increases in pediatric hospitalizations, while Utah had by far the lowest. The all-cause range was fairly narrow, from Utah at 0.85% to Vermont’s 1.14%.
Based on their findings, the researchers offered four pieces of advice for policymakers:
- “Increased pediatric hospitalizations should be anticipated during recessions, and appropriate planning is needed.
- “Special attention should be taken to the needs of children with medical complexity and with diabetes. Children with medical complexity have a risk for mortality five times higher than that of healthy children. Although they represent only 6% of the pediatric population, they account for 34% of pediatric health care spending.
- “Instead of assuming that our findings indicate no impact of recessions on pediatric mental health, public health officials and policymakers should possibly be concerned about the lack of increase in hospitalizations for mental health conditions. A body of literature supports the association of recessions with adverse mental health outcomes in children, including suicide, and raises the possibility of important barriers to mental health care during recessions.
- “State policymakers should also be aware of the marked variability in our findings among the examined states. It is unknown which state policies or programs may explain the variability. Programs and policies related to health care may be implicated, including insurance coverage, availability transportation to medical appointments, and coverage of needed items and services that result in decreased out-of-pocket spending.”
Read more: