Prevalence and characteristics of children with special health care needs

Arch Pediatr Adolesc Med. 2004 Sep;158(9):884-90. doi: 10.1001/archpedi.158.9.884.


Background: Children with special health care needs (SHCNs) are an important population from health care services, economic, and policy perspectives. However, until recently, no national data on their prevalence and health care service needs that use a commonly accepted definition have existed.

Objective: To provide national estimates of the number of children with SHCNs and their characteristics, including an assessment of how well their needs are being met.

Setting: The United States.

Participants: Interviews were conducted by telephone with the families of 38 866 children with SHCNs younger than 18 years using the State and Local Area Integrated Telephone Survey platform developed by the Centers for Disease Control and Prevention, Atlanta, Ga.

Main outcome measures: Prevalence of SHCNs, demographic and socioeconomic correlates of SHCNs, access to care, satisfaction with care, and impact on the family.

Results: An estimated 12.8% of US children experienced an SHCN in 2001. Prevalence was highest among boys, school-age children, and children in lower-income families. A substantial minority of these children experienced unmet health needs (17.7%) or lacked critical elements of family-centered health care (33.5%). The impact on families was pronounced, as 20.9% reported their child's health care caused financial problems, and 29.9% reported cutting back or quitting work because of their child's condition. These adverse child- and family-level impacts were concentrated among low-income and uninsured children with SHCNs.

Conclusions: Children with SHCNs and their families represent an important underserved population. In addition, substantial disparities are present in access, satisfaction, and family impact.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child Health Services* / statistics & numerical data
  • Child Welfare
  • Child, Preschool
  • Disabled Children / statistics & numerical data
  • Family Health
  • Female
  • Health Care Surveys
  • Health Services Accessibility / statistics & numerical data
  • Health Services Needs and Demand* / statistics & numerical data
  • Humans
  • Infant
  • Infant Welfare
  • Infant, Newborn
  • Insurance Coverage / statistics & numerical data
  • Insurance, Health / statistics & numerical data
  • Male
  • Needs Assessment / statistics & numerical data
  • Poverty / statistics & numerical data
  • Prevalence
  • Risk Factors
  • United States / epidemiology