The Disparities
Data on health disparities is potentially confusing, because some data relates to income level of the family and some data relates to the child’s health care coverage: Medicaid, SCHIP (CHP+) or uninsured. For purposes of describing disparities below, low income is considered to be below 133% of the Federal Poverty Level and near poverty is considered to be between 133% and 250% of the FPL. And, 95% are eligible to have health care coverage by Medicaid or CHP+. They experience the following health disparities (as a group their health outcomes are statistically significantly poorer than children on commercial health insurance):
Morbidity and Mortality
- More serious illness (1.77 times)*
- Later diagnosis of serious illness
- More emergency room visits (1.85 times)*
- More hospitalizations (1.73 times)*
- Higher complication rates and poorer outcomes for chronic disease (1.78 times)
- Higher incidence of disabling conditions
- Children on Medicaid are 1.5 times as likely to have multiple, complex conditions
- Higher death rates (1.67 times)*
- Higher infant mortality rates
- Higher cost of care
Lack of Preventive Care – Preventable Conditions
- Lack a medical home (2 times)*
- Less preventive care in general
- Lower proportion of children who are fully immunized
- Higher rates of vaccine-preventable diseases (2.11 times)*
- Admitted to hospital for vaccine-preventable disease (2 times)*
- More dental cavities (2 times)
- Higher rate of obesity
- Higher rates of type II Diabetes (as a result of obesity)
- Asthmatics have higher rates of illness, emergency visits, hospitalization, (2 times), and higher death rates
- Higher rate of developmental delays, which are discovered later, and received therapy less often
- Higher rates of teen depression and are less often treated
- New mothers have higher rates of post-partum depression, which can lead to behavioral and developmental problems in their child
- Higher rates of accidents and injury
- Twice as likely to be a teenage mother with all of the resultant complications for baby
- Lower school attendance due to health conditions
Need for Navigation / Care Coordination
- Less likely to receive health education and less understanding of their illness or condition
- Less understanding of the health care system and how to navigate it
- Less likely to follow treatment plan
- More likely to not read or speak English
- Poor access to specialists
Sources of Data
- The Report on the State of the Health of Colorado’s Children by James Todd, MD, Chief of Pediatric Epidemiology, UC Denver*
- An Assessment Of The Health Needs Of Colorado’s Children In 2010 by The Center for Public Health Practice, Colorado School of Public Health
- Colorado Health Foundation: Colorado Health Report Card
- Colorado Health Disparities Report (2009) – Colorado Office of Health Disparities.
- Colorado Department of Health Care Policy and Financing (HCPF)
- Colorado Department of Public Health and Environment (CDPHE)
- Data Resource Center for Child and Adolescent Health (DRCCAH)