Childhood Disability Policies Should Focus On Low-Income Children, According To UCSF Study

April 09, 1998

Policies to prevent and rehabilitate childhood disabilities should target disadvantaged children -- children below the poverty level -- according to an analysis by health policy experts at the University of California San Francisco and the University of California Los Angeles.

"Children from poor families are at greater risk for disability," according to Paul Newacheck, DrPH, UCSF professor of health policy and pediatrics at the Institute for Health Policy Studies.

Newacheck is the lead author of the analysis, Prevalence and Impact of Disabling Chronic Conditions, published in the April 1998 issue of the American Journal of Public Health.

Newacheck and a research colleague conducted a two-year-long study to determine a current national profile of children with disabilities, including prevalence estimates of chronic conditions causing disabilities. In addition, researchers assessed the effects of disability on the child, the educational system, and the health care system.

Researchers analyzed data from the National Health Interview Survey (NHIS) for 99,513 children younger than 18 years. Children were categorized as "limited in their activity" or "disabled" if their ability to perform the major activity associated with their age group, school or play, was compromised by a chronic condition. Researchers classified children by the degree to which their activities were limited.

Study findings indicated an estimated 6.5 percent of children experienced some degree of disability or 4.4 million U.S. children. Children from poor families as well as older children, boys, and children from single-parent households exhibited significantly higher prevalences of disability.

The main conditions causing disability were: 1) respiratory diseases, 2) impairments of speech and intelligence (principally mental retardation), and 3) mental and nervous system disorders.

"The impact on the child as well as on the educational and health care systems were substantial and profound," according to Newacheck.

Researchers reported the following impacts of disability:"To reduce the impact of disability on children it is important to consider the underlying conditions such as income level and family well-being when developing health and social policies targeted at improving outcomes for these children," Newacheck said.

NHIS is a continuing nationwide cross-sectional survey conducted by household interview by the US Bureau of the Census for the National Center for Health Statistics.

The Institute for Health Policy Studies was established in 1972 within the UCSF School of Medicine. The primary purposes of the institute are 1)to conduct policy-oriented research and analysis on a wide range of health issues; 2) to apply research findings to health policy issues at the national, state, and local levels; and 3) to provide education and training opportunities in health policy and health services research.

Neal Halfon, MD, MPH, professor of pediatrics and public health, UCLA School of Medicine and School of Public Health, is co-author of the study.

University of California - San Francisco

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