Abstract
Objective
To examine access to care and utilization patterns across a set of healthcare measures
by obesity status and socio-demographic characteristics among children.
Methods
Nationally representative data from the Medical Expenditure Panel Survey (2010–2015)
provides data on obesity status, well-child visits, access to a usual source of care
provider, preventive dental visits, and prescription medication fills in the past
year.
Results
Uninsured adolescents with obesity were less likely to have a usual source of care
provider relative to children without obesity (73% vs 65%). Among younger children,
children with obesity were less likely to report a well-child visit (difference of
8 percentage points). Younger children with obesity who lived in the Northeast were
more than twice as likely as those living in the West to have a well-child visit.
Children with obesity were less likely to report preventive dental use relative to
their nonobese counterparts. Obesity status was associated with more prescription
medication fills for adolescents, but not for younger children.
Conclusions
Our findings provide a baseline assessment for examining obesity and utilization trends
among children in the future, especially as coverage patterns change with potential
changes in childhood insurance coverage access through the Child Health Insurance
Programs and Medicaid programs. Our findings highlight new directions for future research,
particularly regarding the lower rates of preventive dental care among children with
obesity.
Keywords
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References
- Annual report on access to and utilization of health care for children and youth in the United States–1999.J Am Pediatr Assn/Pediatrics. 2000; 105: 219-230
- Annual report on access to and utilization of health care for children and youth in the United States-2000.Ambul Pediatrics. 2001; 1: 3-15
- Health care for children and youth in the United States: 2001 Annual report on access, utilization, quality and expenditures.Ambul Pediatr. 2002; 2: 419-437
- Health care for children and youth in the United States: 2002 Report on trends in access, utilization, quality and expenditures.Ambulatory Pediatr. 2004; 4: 131-153
- Health care for children and youth in the United States: annual report on patterns of coverage, utilization, quality, and expenditures by income.Ambulatory Pediatr. 2005; 5: 6-44
- Health care for children and youth in the United States: annual report on patterns of coverage, utilization, quality, and expenditures by a county level of urban influence.Ambulatory Pediatr. 2006; 6: 241-264
- Annual report on health care for children and youth in the United States: focus on injury-related emergency department utilization and expenditures.Ambul Pediatr. 2008; 8: 219-240
- Annual report on health care for children and youth in the United States: racial/ethnic and socioeconomic disparities in children's health care quality.Acad Pediatrics. 2010; 10: 95-118
- Annual report on health care for children and youth in the United States: focus on trends in hospital use and quality.Acad Pediatrics. 2011; 11: 263-279
- Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009.Acad Pediatr. 2013; 13: 191-203
- Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.Acad Pediatr. 2015; 15: 19-35
- Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016.JAMA. 2018; 319: 1723-1725
- Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014.JAMA. 2016; 315: 2292-2299https://doi.org/10.1001/jama.2016.6361
- Increasing socioeconomic disparities in adolescent obesity.PNAS. 2014; 111: 1338-1342
- National, state, and local disparities in childhood obesity.Health Affairs. 2010; 29: 347-356
- Differences in obesity prevalence by demographics and urbanization in US children and adolescents, 2013-2016.JAMA. 2018; 319: 2410-2418
- Childhood obesity.Lancet. 2010; 375: 1737-1748
- Tracking of body mass index in children in relation to overweight in adulthood.Am J Clin Nutr. 1999; 70: 145S-148S
- Overweight children and adolescents.N Engl J Med. 2005; 352: 2100-2109
- Prevalence and trends in obesity among US adults, 1999-2000.JAMA. 2002; 288: 1723-1727
- The Impact of obesity on health service utilization and costs in childhood.Obesity. 2009; 17: 1749-1754
- Differences in bone mineral density between normal‐weight children and children with overweight and obesity: a systematic review and meta‐analysis.Obesity Rev. 2017 May; 18: 526-546
- Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17.Acad Pediatr. 2013; 13: 6-13
- Simulation of growth trajectories of childhood obesity into adulthood.N Engl J Med. 2017; 377: 2145-2153
- Overweight in adolescents: implications for health expenditures.Econ Hum Biol. 2009; 7: 55-63
Biener, AI, J Cawley, C Meyerhoefer. 2017. The medical care costs of youth obesity: an instrumental variables approach. NBER Working Paper #23682.
- The impact of obesity on medical care costs and labor market outcomes in the U.S.Clin Chem. 2018; 64: 108-117
- The economic burden placed on healthcare systems by childhood obesity.Expert Rev Pharmacoecon Outcomes Res. 2012; 12: 39-45
- Economic impact of childhood obesity on health systems: a systematic review.Obesity Rev. 2012; 13: 431-440
- Effects of childhood obesity on hospital care and costs, 1999-2005.Health Affairs. 2009; 28: 751-760
- The impact of obesity on health service utilization and costs in childhood.Obesity. 2009; 17: 1749-1754
- Effects of overweight and obesity on motor and mental development in infants and toddlers.Pediatric Obes. 2016; 11: 389-396
- Richness of human gut microbiome correlates with metabolic markers.Nature. 2013; 500: 541
American Academy of Pediatrics. Reaffirmed policy statement—pediatric primary health care. Pediatrics. 2011;127:397. American Academy of Pediatrics. Medical Home.https://www.aap.org/en-us/about-the-aap/aap-facts/AAP-Agenda-for-Children-Strategic-Plan/Pages/AAP-Agenda-for-Children-Strategic-Plan-Medical-Home.aspx. Accessed May 3, 2019.
- Oral Health in America: A Report of the Surgeon General.United States Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institues of Health, Rockville, MD2000
- The Surgeon General's Vision for a Healthy and Fit Nation.U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MD2010
- Reporting error in weight and its implications for bias in economic models.Econ Hum Biol. 2015; 19: 27-44
- Parental misclassification of child overweight/obese status: the role of parental education and parental weight status.Econ Hum Biol. 2016; 24: 92-103
- Adjusting body mass for measurement error with invalid validation data.Econ Hum Biol. 2015; 19: 275-293
- Prevalence of obesity and severe obesity in US children, 1999-2014.Obesity. 2016; 24: 1116-1123
- Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.Obesity. 2017; 25: 16-29
- Examining the evidence for policy and environmental strategies to prevent childhood obesity in black communities: new directions and next steps.Obesity Rev. 2014; 15: 177-203
- Obesity in children is associated with increased health care use.Clin Pediatrics. 2009; 48: 812-818
- The relationship among child weight status, psychosocial functioning, and pediatric health care expenditures in a Medicaid population.J Pediatr Psychol. 2010; 35: 883-891
- Health status, emotional/behavioral problems, health care use, and expenditures in overweight/obese US children/adolescents.Acad Pediatrics. 2013; 13: 251-258
- Oral Health in America: A Report of the Surgeon General.U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, Rockville, MD2000 (Downloaded)
- The economics of childhood obesity.Health Affairs. 2010; 29: 364-371
Article Info
Publication History
Published online: December 13, 2019
Accepted:
November 16,
2019
Received:
May 31,
2019
Footnotes
The views expressed in this article are those of the authors and do not necessarily represent those of the Agency for Healthcare Research and Quality or the US Department of Health and Human Services.
The authors have no conflicts of interest to disclose.
Identification
Copyright
Published by Elsevier Inc. on behalf of Academic Pediatric Association
