Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders in Early Childhood — United States, 2011–2012
Purpose To identify sociodemographic, healthcare, family, and community factors associated with mental, behavioral, or developmental disorders (MBDDs) in early childhood within a nationally representative U.S. sample. Methods As part of the National Survey of Children’s Health, parents of 35,121 children aged 2-8 years reported whether a health care provider ever told them their child had any of the following MBDDs: attention-deficit/hyperactivity disorder, depression, anxiety problems, behavioral or conduct problems, Tourette syndrome, autism spectrum disorder, learning disability, intellectual disability, developmental delay, and speech or other language problems. Prevalence of any MBDD was calculated, as were prevalence ratios (PR) with sociodemographic, health care, family, and community factors. Analyses were conducted using SUDAAN 11.0.0 to account for the complex sampling design. Results reflect the population of noninstitutionalized 2-8 year olds in the U.S. Results 15.4% (95% CI: 14.6-16.2) had a diagnosed MBDD; they were more common among boys, 6-8 year olds, non-Hispanic whites, in households < 100% federal poverty level, and in English-speaking households (all PR≥1.3; p < 0.05). Factors most strongly associated with MBDDs included health care factors (inadequate insurance, lacking a medical home), family factors (fair or poor parent mental health, difficulty getting by on family’s income), and community factors (living in a neighborhood in poor condition or that lacks support) (see Table; all PR≥1.3; all p < 0.01). Conclusions These data support the Institute of Medicine recommendation that resources directed toward improving health care and supporting families and communities are needed to promote healthy development of young children. Future analyses may reveal more about the direct associations between individual, family and community factors and specific disorders.
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