Abstract
Purpose: To examine geospatial gaps in identification and evaluation of children with special healthcare needs (CSHCN) within public child development centers (CDCs).Methods: A descriptive geospatial design was used to visually depict service gaps, proximity, and clustering of area-level sociodemographic attributes of Virginia counties, and patient-level data within each CDC.Results: Geospatial analysis shows population density of uninsured children against CDC resources. Data visualization facilitates policy advocacy based on the identification of care and screening gaps for CSHCN.Conclusion: This project illustrates the collaborative potential between researchers and Health Department members to identify gaps in access to care.
Highlights
Access to care for children with special healthcare needs (CSHCN) disproportionately affects those living in rural areas
There are several counties in Regions 2 and 3 with >500 uninsured children
By using geographic information systems (GIS) mapping software to show the state of Virginia by population density of uninsured children as well as available CDC resources, we have demonstrated the value of visualizing potential gaps in care and screening of children with developmental conditions and other special healthcare needs
Summary
Access to care for children with special healthcare needs (CSHCN) disproportionately affects those living in rural areas. CSHCN are defined as ‘‘those who have, or are at increased risk for, a chronic physical, developmental, behavioral, or emotional condition and who require health and related services of a type or amount beyond that required by children generally.’’1 As many as 23% of households have at least one child with special healthcare needs, with estimates of 11.2 million of those under the age of 18 in the United States being identified as CSHCN.[2] Children with mental, behavioral, and developmental disorders are more prevalent in small rural areas (18.6%) than in urban dwellings (15.2%).[3] These childhood conditions are associated with poor mental health of the parents, financial and child care difficulties, and a lack of coordinated medical care and medical homes.[4] Rural parents of CSHCN are more likely than their urban counterparts to report difficulty with transportation to appointments and lack of service availability in their region, therapy and mental healthcare counseling.[5] Rural families, who are more likely to lack resources as well as to have limited access, may, rely on safety net services provided by public health departments. These providers need the ability to assess their reach into rural areas
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