[2600.3] Childhood Disability Trends, 2000-2010
Amy Houtrow, Kandyce Larson, Paul Newacheck, Neal Halfon. Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PS; Pediatrics, University of California, Los Angeles, Los Angeles, CA; Pediatrics and Health Policy, University of California, San Francisco, San Francisco, CA.
BACKGROUND: A century of advances have changed the face of childhood chronic disease and disability. Although numerous studies document changes in prevalence for certain disabling conditions, no recent studies have documented the changing landscape of childhood disability.
OBJECTIVE: The purpose of this study was to evaluate trends in childhood disability over the past decade to assess changes in prevalence and severity in relationship to socio-demographic factors.
DESIGN/METHODS: The National Health Interview Survey datasets from 2001-02 and 2009-10 were used for these analyses. Children aged 0-17 years were included in the analysis (N=102,468). Using questions administered in the household survey, a composite of developmentally appropriate activity limitations were used to identify children with disabilities and to determine prevalence of underlying chronic conditions. Conditions were categorized into 3 groups: physical, neurodevelopmental/mental health, and other. Bivariate and multivariable analyses were conducted to assess socio-demographic disparities.
RESULTS: The prevalence of disability increased 16.3% between 2001/02 and 2009/10. Nearly 6 million children were considered disabled in 2009/10. Children living in poverty experienced the highest rates of disability but not the highest growth: 92.7 cases/1,000 in 2001/02 and 101.4 cases/1,000 in2009/10. Only children living in households with incomes 300-399% of the federal poverty level (FPL) and 400% or above the FPL experienced statistically significant increases in disability rates over the study period (28.0% and 23.9%, respectively). Rates of disability due to physical conditions declined while disability due to neurodevelopmental/mental health conditions increased. This trend was most pronounced among children under six years who experienced a near doubling of neurodevelopmental/mental health conditions (18.7 to 35.6 cases/1,000, p<0.05).
CONCLUSIONS: Disability in childhood is on the rise. Over the past decade there has been a decline in disability due to physical health conditions but a large increase in disabilities related to neurodevelopmental/mental health problems. The rise is occurring primarily among socially advantaged families highlighting the importance of focusing on under-recognized social, medical and environmental trends. Knowing the extent and characteristics of childhood disability is an important first step in refining how we study disability, and how we create and refine services to best meet the needs of children.
Session: Presidential Plenary: 2013 AAP Presidential Plenary & Annual Silverman Lecture (12:30 PM - 4:00 PM)
Date/Time: Sunday, May 5, 2013 - 1:05 PM
Room: 146B - Walter E. Washington Convention Center
Course Code: 2600