ArticleAcademic pediatrics2026
Disparities in Health Insurance and Health care Access for Immigrant Children With Special Health care Needs.
Article in Academic pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
objectiveOur objective was to examine health care access disparities for children and youth with special health care needs (CYSHCN), comparing immigrant and US-born CYSHCN.
methodsThis was a cross-sectional, retrospective study of 2016 to 2022 National Survey of Children's Health data including CYSHCN. The primary exposure was child nativity. Primary outcomes were adequate health insurance, usual place for primary care, usual place for sick care, foregone medical care, and difficulty with referrals. We calculated descriptive frequencies and performed univariate analyses with the chi-square statistic. We then estimated multivariable logistic regression models evaluating each of the 5 outcomes, adjusting for individual and state-level characteristics.
resultsFrom 2016 to 2022, 62,391 US-born children and 1733 immigrant children were identified as CYSHCN [population estimates: US-born 13,518,819 (19.5%), immigrant 462,757 (14.9%)]. Immigrant compared to US-born CYSHCN had higher rates of inadequate insurance, not having a usual place of primary care, and not having a usual place for sick care (P<.001). In multivariable models, immigrant CYSHCN had lower odds of uninterrupted health insurance (aOR 0.57, 95%CI 0.37, 0.87), usual place for primary care (aOR 0.59, 95%CI 0.37, 0.92), and usual place for sick care (aOR 0.67, 95%CI 0.50, 0.89) compared to US-born CYSHCN. There were no statistically significant differences for foregone medical care or difficulty with referrals.
conclusionsImmigrant compared to US-born CYSHCN in our study had worse access to health insurance, primary care, and sick care. Given the significant health care needs of CYSHCN, these health disparities must be addressed to improve their health outcomes.
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