Inequities in Children's Healthcare Utilization and Quality: Links with Caregiver’s Self-Rated Mental Health

Open Access
Hatzell, Jane
Area of Honors:
Biobehavioral Health
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Lori Anne Francis, Thesis Supervisor
  • Helen Marie Kamens, Honors Advisor
  • Healthcare
  • Healthcare Inequities
  • Mental Health
  • Children's Health
Background: A significant proportion of the population suffers from mental illness, but services are often underutilized due to a variety of factors, including sociodemographics and fear of stigma (McAlpine & Mechanic, 2000). This is a serious public health concern, given that mental illness can heighten the risk of other diseases (Parks, Svendsen, Singer, Foti, & Mauer, 2006) and may negatively impact interpersonal relationships. Objectives: The goal of this study was to examine the ways in which a caregiver’s mental health status impacts their child’s healthcare utilization and quality, as well as general health status. It was also of interest to determine whether health disparities by race, ethnicity, and language exist within caregivers with poor self-reported mental health. Methods: The 2016 National Survey of Children’s Health was utilized for the current study. Caregivers were categorized into excellent/very good and poor/fair self-reported mental health groups in order to examine differences in their child’s health and healthcare experiences. Associations for caregivers rated in the poor mental health group were further examined by race, ethnicity, and language. Results: Children with caregivers who reported poor/fair health had a significantly higher odds of having a child who experienced unmet healthcare needs and were rated in poor/fair general health compared to caregivers in the excellent/very good mental health group. Caregivers in poor/fair mental health were also more likely to report having trouble paying for care. In addition, a greater frequency of Hispanic caregivers in poor/fair mental health reported unmet healthcare needs and not having a usual place for preventive care compared to White individuals in poor/fair mental health. Conclusions: Children who have caregivers with poor mental health are a hidden population that is in need of improvements in healthcare. Integrated, patient-centered care is an important method for improving care in adults suffering from mental illness, which would ultimately improve the lives of children in these families as well.