Disparities in Health Care Transition Preparation Among US Youth

Pediatrics. 2025 Oct 1;156(4):e2024066905. doi: 10.1542/peds.2024-066905.

Abstract

Objectives: Research pertaining to disparities in access to health care transition preparation is limited. This study examined a broad set of individual, family, and health system characteristics to determine which are associated with disparities in receipt of health care transition preparation services among US youth.

Methods: This cross-sectional study used data from the 2018-2022 National Survey of Children's Health, a nationally representative survey based on responses from parents or caregivers. We conducted bivariate analyses to examine receipt of health care transition preparation among youth aged 12 to 17 years (N = 77 280) and multivariable logistic regression models to estimate associations with covariates of interest.

Results: Only 18% of youth with and without special health care needs received health care transition preparation services from their health care professionals. In adjusted analyses, youth who were male, aged between 12 and 14 years, and who were Hispanic, non-Hispanic Black, and non-Hispanic Asian were significantly less likely to receive recommended health care transition services. Health care transition preparation was also less likely among youth without special health care needs, without care in a medical home, without insurance, and from households with a high school education only. There were also state-level variations in health care transition preparation (range: 11%-32%).

Conclusions: Prevalence of receipt of health care transition preparation services is low among all youth. Findings from this study draw attention to subgroups of youth least likely to receive guidance about health care transition preparation. Health care professionals should be supported to develop clinical and system-level interventions to improve health care transition preparation.

MeSH terms

  • Adolescent
  • Child
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility* / statistics & numerical data
  • Healthcare Disparities* / statistics & numerical data
  • Humans
  • Male
  • Transition to Adult Care*
  • United States