Article Figures & Data
Tables
Characteristics Frequency, n (%) Child Age, y <1a 79 (32) 1–4 60 (24) 5–9 41 (16) 10–14 39 (16) 15–18 30 (12) Sex, female 119 (48) Race or ethnicity White 203 (84) Black or African American 5 (2) Asian American 6 (2) Native Hawaiian or other Pacific Islander 1 (<1) American Indian or Alaska Native 3 (1) >1 race or other 23 (10) Hispanic or Latino ethnicity 51 (21) Public health insurance 169 (68) Caregiver Median age in years, min–max 35, 16–70 Sex, female 205 (82) Race or ethnicity White 179 (75) Black or African American 4 (2) Asian American 9 (4) Native Hawaiian or Pacific Islander 2 (1) American Indian or Alaska Native 7 (3) >1 race or other 33 (14) Hispanic or Latino ethnicity 53 (22) Marriedb 139 (56) Survey language, Spanish 20 (8) Education Less than high school degree 31 (13) High school or equivalent 99 (40) Specialized training or associate’s degree 59 (24) College degree or higher 59 (24) Biological or adoptive parent 238 (96) Demographics were otherwise evenly distributed among children with or without chronic disease.
↵a Children younger than age 1 were more likely to not have any chronic disease (P < .001).
↵b Caregivers of children with chronic diseases were more likely to be separated, divorced, or widowed compared with those without chronic disease (P = .004).
Health Characteristics Overall (N = 249) No Chronic Disease (n = 133) Noncomplex Chronic Disease (n = 44) Complex and Chronic Disease (n = 72) Pa General health status, n (%) <.001 Not very good or poor 44 (18) 11 (8) 10 (23) 23 (32) Hospitalizations in previous 12 mo, n (%) <.001 0 129 (52) 87 (66) 24 (55) 18 (25) 1 67 (27) 32 (24) 14 (32) 21 (29) 2 or more 52 (21) 13 (10) 6 (14) 33 (46) Visits to ED in previous 12 mo, n (%) <.001 0–1 159 (64) 101 (77) 26 (59) 32 (44) 2–4 74 (30) 27 (20) 16 (36) 31 (43) 5 or more 15 (6) 4 (3) 2 (5) 9 (13) Hours per week providing or coordinating care, n (%) <.001 <1 h per wk 143 (58) 112 (86) 18 (41) 13 (18) 1–10 h per wk 44 (18) 11 (8) 13 (30) 20 (28) 11 or more h per wk 58 (24) 7 (5) 13 (30) 38 (54) History or current concern for anxiety and/or depression, n (%) 30 (12) 10 (8) 12 (28) 8 (11) .002 ↵a P value from χ2 test of association between medical complexity and potential risk factor. Cell counts may not sum to column totals in cases of excluded nonresponse (n = 0–4, except child or caregiver histories of behavioral or psychological concern, with 8 and10 nonresponses, respectively).
Socioeconomic Risk Factors Overall (N = 249) No Chronic Disease (n = 133) Noncomplex Chronic Disease (n = 44) Complex and Chronic Disease (n = 72) Pa Financial stress, any, n (%) 85 (34) 39 (29) 19 (43) 27 (38) .19 Having enough money for food 66 (27) 29 (22) 16 (36) 21 (29) .14 Paying for utilities and services (gas, water, etc) 64 (26) 28 (21) 14 (32) 22 (31) .20 Paying rent or mortgage 60 (24) 25 (19) 16 (36) 19 (26) .05 Working appliances (stove, refrigerator, etc) 47 (19) 25 (19) 9 (20) 13 (18) .95 Housing concerns, n (%) Infestation problems (ie, mold, insects, rats or mice) 19 (8) 9 (7) 5 (11) 5 (7) .59 Unstable housing (ie, eviction, foreclosure, homelessness) 13 (5) 6 (5) 4 (9) 3 (4) .44 Medical bills and insurance stress, any, n (%) 91 (37) 44 (33) 20 (45) 27 (38) .33 Problems paying child’s health care bills 54 (22) 29 (22) 10 (23) 15 (21) .98 Issues paying other family members’ health care bills 47 (19) 23 (17) 11 (25) 13 (18) .52 Caregiver or household member without health insurance 24 (10) 14 (11) 3 (7) 7 (10) .76 Child without health insurance in past 12 mo 18 (7) 11 (8) 3 (7) 4 (6) .76 No regular doctor for child or other household member 16 (6) 7 (5) 8 (18) 1 (1) .001 Employment concerns, any, n (%) 83 (33) 39 (29) 20 (45) 24 (33) .14 Time off or changing responsibilities to care for a child 52 (21) 19 (14) 14 (32) 19 (26) .02 Finding a job 28 (11) 15 (11) 5 (11) 8 (11) .99 Disability interfering with work 24 (10) 10 (8) 8 (18) 6 (8) .10 Unpaid wages, worker’s compensation, discrimination, etc 11 (4) 9 (7) 1 (2) 1 (1) .15 ↵a P value from χ2 test of association between medical complexity and potential risk factor.
Household Risk Factors Overall (N = 249) No Chronic Disease (n = 133) Noncomplex Chronic Disease (n = 44) Complex and Chronic Disease (n = 72) Pa No. children under age 18 in the home, n (%) .21 1–3 204 (83) 108 (84) 33 (75) 63 (88) 4 or more 41 (17) 21 (16) 11 (25) 9 (13) No. additional children in household with a chronic condition, n (%) <.001 0 137 (56) 92 (72) 21 (49) 24 (33) 1 85 (35) 30 (23) 16 (37) 39 (54) 2 or more 21 (9) 6 (5) 6 (14) 9 (13) School-aged child missed 10 or more d of school in past year, n (%) 55 (53) 17 (40) 10 (42) 28 (76) .003 No. people age 18 and older in the home, n (%) .87 1–2 154 (63) 81 (63) 29 (66) 44 (61) 3 or more 91 (37) 48 (37) 15 (34) 28 (39) Caregiver general health status, n (%) .96 Not very good or poor 16 (6) 8 (6) 3 (7) 5 (7) Caregiver behavioral or psychological concern, n (%) Anxiety and/or depression 60 (25) 31 (24) 11 (26) 18 (26) .96 ADD/ADHD, substance abuse, or other 30 (13) 16 (13) 5 (12) 9 (13) .98 Caregiver has social or emotional support present 218 (88) 115 (86) 41 (93) 62 (86) .46 Concerns caring for pet while child is ill, n (%) 23 (9) 13 (10) 3 (7) 7 (10) .82 General issues with transportation, eg, work, grocery store, etc, n (%) 20 (8) 12 (9) 3 (7) 5 (7) .80 Transportation is 100% reliable, n (%) 219 (88) 117 (88) 38 (86) 64 (89) .91 ADD, attention-deficit disorder; ADHD, attention-deficit hyperactivity disorder; —, not applicable.
↵a P value from χ2 test of association between medical complexity and potential risk factor.
Trauma or ACEs (No. who declined to respond) Overall (N = 249) No Chronic Disease (n = 133) Noncomplex Chronic Disease (n = 44) Complex and Chronic Disease (n = 72) Pa n (%) n (%) n (%) n (%) Any ACEs reported (4) 92 (38) 38 (29) 21 (48) 33 (46) .017 4 or more ACEs reported (4) 22 (9) 10 (8) 5 (11) 7 (10) .70 Parent or guardian divorced or separated (6) 58 (24) 21 (16) 14 (32) 23 (32) .016 Been involved with Child Protective Services (11) 31 (13) 15 (12) 5 (12) 11 (16) .73 Lived with anyone who had a problem with alcohol or drugs (7) 27 (11) 13 (10) 7 (16) 7 (10) .54 Lived with anyone who was mentally ill, suicidal, or severely depressed (6) 25 (10) 12 (9) 7 (16) 6 (8) .39 Parent or guardian served time in jail (5) 20 (8) 8 (6) 6 (14) 6 (8) .30 Was a victim of violence or witnesses violence in neighborhood (4) 19 (8) 6 (5) 4 (9) 9 (13) .12 Saw or heard parents or adults slap, kick, or punch one another (6) 16 (7) 5 (4) 2 (5) 9 (13) .048 Parent or guardian died (5) 10 (4) 3 (2) 1 (2) 6 (8) .09 Been involved in the juvenile justice system (6) 10 (4) 5 (4) 2 (5) 3 (4) .98 Treated or judged unfairly because of his or her race or ethnic group (4) 8 (3) 5 (4) 0 (0) 3 (4) .40 ↵a P value from χ2 test of association between medical complexity and potential risk factor.
Additional Files
Data Supplement
In this issue
Identification of Caregiver-Reported Social Risk Factors in Hospitalized Children
