National Health Interview Study Research Articles

Exploring Disparities in Cancer Screening Among Women With Disabilities [ID 2683490

INTRODUCTION: Unequal access to health care for individuals with disabilities is an increasingly relevant disparity. Further, accessibility to cancer screening remains inadequate. Steele et al. (2017) reported a lower prevalence of women with disabilities undergoing screening for cancer versus women overall in the 2013 National Health Interview Study. The purpose of this study is to compare screening rates for breast, cervical, and colon cancer among female patients with and without disabilities within our health network. METHODS: The study is a retrospective review of patient charts between January 1, 2015 and January 1, 2020. Sample size calculations yielded need for 450 charts to achieve adequate power to detect a 10% reduction in each of the three screening rate analyses. Sample was drawn from electonic medical records and identified female patients ages 21–75 receiving gynecologic care at an eastern Pennsylvania health network. ICD-10-CM codes for disabilities identified patients with cognitive, mobility, speech, or hearing impairments. Statistical analyses included chi-squared goodness-of-fit tests. RESULTS: Cancer screening rates were significantly lower in the sample population. For cervical cancer, patients with disabilities had a 43.3% screening rate versus 66.0% in the general population. For breast cancer, the sample screened at 67.6% versus the general population at 75.0%. For colorectal cancer screening, the sample was at 54.8%, whereas the general population had a 66.0% screening rate (P<.001). CONCLUSION: Understanding the mechanisms behind lower preventive care rates can help to improve health outcomes for this patient population. The future goal is to offer solutions to address disparities in cancer screening.

Educational Inequalities in Dual-Function Life Expectancy.

This study investigates educational inequalities in dual functionality, a new concept that captures a combination of physical and cognitive functioning, both of which are important for independent living and quality of life. Using data from the Health and Retirement Study and the National Health Interview Study Linked Mortality Files, we define a measure of dual functionality based on the absence of limitations in activities of daily living and dementia. We estimate age-graded dual-function rates among adults 65+ and age-65 dual-function life expectancy across levels of education stratified by gender. In their mid 60s, 67 percent of women with less than a high school degree manifest dual functionality as compared with over 90 percent of women with at least a four-year college degree. A similar pattern holds among men. These education-based gaps in dual functionality remain across later life, even as dual-function rates decline at older ages. Lower dual-function rates among older adults with less education translate into inequalities of 6.7 and 7.3 years in age-65 dual-function life expectancy between men and women respectively with at least a four-year college degree compared to their counterparts with less than a high school degree. Older adults, particularly women, with less than a high school degree are estimated to live a smaller percentage of their remaining years with dual functionality compared with older adults with at least a college degree. These inequalities have implications for the distribution of caregiving resources of individuals, family members, and the broader health care community.

Consequences of deferred action for childhood arrivals for parent health: Applying a social foreground perspective

AbstractObjectiveThis study applies a social foreground perspective to assess whether the Deferred Action for Childhood Arrivals (DACA) program impacted the self‐rated health of coresident parents of DACA‐eligible individuals.BackgroundDACA status grants a temporary work permit and allows for a stay of deportation for undocumented persons who entered the United States as children. Although research points to the positive health benefits of DACA for its recipients, less is known about whether the program affects the health of family members, including parents.MethodThis study uses data from the National Health Interview Study (2008–2015) on foreign‐born adults and their coresident parents. We applied a difference‐in‐differences design to examine whether the self‐rated health of coresident mothers and fathers changed following the passage of DACA for DACA‐eligible individuals.ResultsIn contrast to expectations, DACA was associated with worse self‐rated health among coresident, partnered parents. These results may be because DACA also decreased the likelihood of coresiding with parents and changed the composition of coresident parents themselves. Following DACA, fewer eligible offspring lived with parents overall, but among those that did, parents tended to be older and less healthy.ConclusionFindings underscore how DACA may be used as a resource to support older parents experiencing health challenges, in particular among older undocumented immigrants, who make up a growing share of the undocumented population in the United States.

Healthcare Utilization Among Adults With Vestibular Vertigo in the United States.

Vestibular vertigo has been shown to have a high lifetime prevalence. Previous studies have described the increased morbidities associated with vestibular vertigo. In this cross-sectional study of the 2016 National Health Interview Study, we sought to explore whether individuals with vestibular vertigo were more likely to utilize healthcare resources compared with those without vestibular vertigo. We characterized utilization of specific healthcare resources including general doctors, specialist doctors, emergency departments, mental health professionals, and others among individuals with vestibular vertigo to better understand how individuals with vertigo interact with the US healthcare system. In multivariable analyses, participants with vestibular vertigo had an increased number of nights in the hospital in the last 12 months (mean difference = 0.67 days, 95% confidence interval [CI] = 0.37 to 0.97), increased odds of receiving healthcare 10 or more times in the last 12 months (odds ratio = 2.22, 95% CI = 1.99 to 2.48) and increased number of visits to a healthcare professional in the last 2 weeks (mean difference = 0.17 visits, 95% CI = 0.14 to 0.21). In addition, participants with vestibular vertigo had increased odds of visiting both general doctors, specialist doctors, and other healthcare professionals. These findings characterize how individuals with vestibular vertigo utilize and interact with healthcare resources compared with those without vestibular vertigo.

Are Interracial Couples at Higher Risk of Multiple Chronic Conditions? Evidence from a Nationally Representative Sample.

Interracial relationships are becoming increasingly common in the United States, yet the physical health status of individuals in interracial relationships is not well understood. Using 18years of pooled data from the National Health Interview Study (2001-2018) (N = 264, 891), we compared the odds of having multiple chronic conditions (MCC) among adults in interracial and same-race unions. We anticipate that individuals in interracial relationships may be at higher risk of MCC than individuals in same-race relationships due to increased exposure to stressors associated with crossing racial boundaries. Findings indicate that the implications of interracial relationships on MCC depended on the racial composition of the couple. We found that White-Black couples had higher odds of MCC than both White-White and Black-Black couples, but Asian-Black and Hispanic-Black couples did not differ from their same-race couple counterparts, indicating a pronounced and unique health disadvantage for White adults paired with Black adults. We also found that Asian-White and Hispanic-White couples had higher odds of MCC relative to their same-race counterparts. In addition, minority-minority couples generally did not differ from their same-race minority couple counterparts in terms of MCC. The results of the study provide new insights into how the racial composition of interracial unions impacts health and how a closer proximity to Whiteness may be a health risk for some minority groups.

Cancer and the family: Variations by sex and race/ethnicity.

Cancer affects patients and their families, but few data are available on factors associated with diversity of family structures among patients with cancer. Family is a source of both support and responsibility that must be understood to support patients and their families. Pooled data (2004-2015) from the National Health Interview Study were used to compare characteristics of cancer survivors with and without minor children and differences by sex and race/ethnicity among survivors with minor children. 13.9% of cancer survivors have minor children in the household, and this experience is more likely for women and people who identify as other than non-Hispanic White. There are considerable differences by sex and race/ethnicity in the characteristics of cancer survivors with minor children. Clinicians should make consideration of family circumstances a routine part of their history. Doing so will help to identify potential sources of support and responsibility that may affect adherence.

Rural-Urban Differences in Health Care Unaffordability During the Postpartum Period.

The objective of this study was to examine health care unaffordability for rural and urban residents and by postpartum status. We used cross-sectional survey data on female-identifying respondents ages 18-44 (n=17,800) from the 2019 to 2021 National Health Interview Study. Outcomes of interest were 3 measures of health care unaffordability. We conducted bivariate and multivariable regression models to assess the association between health care unaffordability, rurality, and postpartum status. Bivariate analyses showed postpartum people reported statistically significantly higher rates of being unable to pay medical bills and having problems medical paying bills, as compared with nonpostpartum people. Rural residents also reported statistically significantly higher rates of being unable to pay their medical bills and having problems paying medical bills as compared with urban residents. In adjusted models, the predicted probability of being unable to pay medical bills among postpartum respondents was 12.8% (CI, 10.1-15.5), which was statistically significantly higher than among nonpostpartum respondents. Similarly, postpartum respondents had statistically significantly higher predicted probabilities of reporting problems paying medical bills (18.4%, CI, 15.4-21.4) as compared with nonpostpartum respondents. The rural residency was not significantly associated with the health care unaffordability outcome measures in adjusted models. Both postpartum and rural respondents reported higher rates of being unable to pay medical bills and having problems paying medical bills; however, after adjusting for covariates, only postpartum respondents reported statistically significantly higher rates of these outcomes. These results suggest that postpartum status may present challenges to health care affordability that span the urban/rural context.

Body mass index and all-cause mortality in a 21st century U.S. population: A National Health Interview Survey analysis.

Much of the data on BMI-mortality associations stem from 20th century U.S. cohorts. The purpose of this study was to determine the association between BMI and mortality in a contemporary, nationally representative, 21st century, U.S. adult population. This was a retrospective cohort study of U.S. adults from the 1999-2018 National Health Interview Study (NHIS), linked to the National Death Index (NDI) through December 31st, 2019. BMI was calculated using self-reported height & weight and categorized into 9 groups. We estimated risk of all-cause mortality using multivariable Cox proportional hazards regression, adjusting for covariates, accounting for the survey design, and performing subgroup analyses to reduce analytic bias. The study sample included 554,332 adults (mean age 46 years [SD 15], 50% female, 69% non-Hispanic White). Over a median follow-up of 9 years (IQR 5-14) and maximum follow-up of 20 years, there were 75,807 deaths. The risk of all-cause mortality was similar across a wide range of BMI categories: compared to BMI of 22.5-24.9 kg/m2, the adjusted HR was 0.95 [95% CI 0.92, 0.98] for BMI of 25.0-27.4 and 0.93 [0.90, 0.96] for BMI of 27.5-29.9. These results persisted after restriction to healthy never-smokers and exclusion of subjects who died within the first two years of follow-up. A 21-108% increased mortality risk was seen for BMI ≥30. Older adults showed no significant increase in mortality between BMI of 22.5 and 34.9, while in younger adults this lack of increase was limited to the BMI range of 22.5 to 27.4. The risk of all-cause mortality was elevated by 21-108% among participants with BMI ≥30. BMI may not necessarily increase mortality independently of other risk factors in adults, especially older adults, with overweight BMI. Further studies incorporating weight history, body composition, and morbidity outcomes are needed to fully characterize BMI-mortality associations.

Understanding the Predictors of Low Take-Up of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): A Nationwide Longitudinal Study

IntroductionThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is among the largest U.S. social safety net programs. Although strong evidence exists regarding the benefits of WIC, take-up (i.e., participation among eligible individuals) has steadily declined in the past decade. This study addresses gaps in our knowledge regarding predictors of WIC take-up during this time.MethodsData were drawn from the 1998–2017 waves of the National Health Interview Study (NHIS), a serial cross-sectional study of the U.S. population. The analytic sample included 23,645 children and 10,297 women eligible for WIC based on self-reported demographic characteristics. To investigate predictors of WIC take-up, we regressed self-reported WIC receipt on a range of individual-level predictors (e.g., age, nativity, income) and state- level predictors (e.g., unemployment rate, governor’s political affiliation) using multivariable logistic regression. In secondary analyses, results were additionally stratified by race/ethnicity, time period, and age (for children).ResultsFor both women and children, older maternal age and higher educational attainment were associated with decreased take-up of WIC. Associations differed by race/ethnicity, time period, and state characteristics including caseload of other social programs (e.g., Medicaid).DiscussionOur study identifies groups that are less likely to take up WIC benefits for which they are eligible, thereby contributing important evidence to inform programs and policies to increase WIC participation among groups with lower take-up. As WIC evolves past the COVID-19 pandemic, special attention will be needed to ensure that resources to encourage and support the participation of racially and economically marginalized individuals are equitably distributed.

The moderating effects of alcohol use on the association between sexual orientation and HIV testing: results from the 2013–2018 National Health Interview Study

ABSTRACT Routine screening and testing for HIV are recommended for all adolescents and adults. However, only one-third of the U.S. population has been tested for HIV. Women, sexual minorities, and people who use alcohol are more likely to be tested for HIV, but less is known about how alcohol use and sexual orientation impact the likelihood of HIV testing synergistically. Examining both alcohol use and sexual orientation is especially relevant, because sexual minorities are at increased risk for alcohol use, including heavy drinking. This study tested an alcohol x sexual orientation interaction effect on HIV testing through logistic regression modeling with a nationally representative sample. Results of the significant interaction identify demographic groups that are particularly at-risk for not being tested for HIV. These groups include lesbian women who currently use alcohol or previously used alcohol; bisexual men who have not used or previously used alcohol; and gay men who previously used alcohol. Although efforts to test all adolescents and adults are warranted, these findings highlight the importance of assessing alcohol and sexual orientation and augmenting testing efforts for highrisk groups.

Progressive Trends of Childhood Immunization in Rajasthan: A study based on the NFHS database

Any public health program's efficacy may be evaluated solely based on the available statistics. A program's ability to be tracked relies heavily on data. There are several systems in place in India for gathering data on the health of individual states and the country as a whole. The National Family Health Survey (NFHS) is one of these mechanisms. Children's vaccination status is one of the many data points collected by the National Health Interview Study (NFIS), a representative sample survey. NFHS is commonly used to evaluate and monitor the progress of any health program in the country, therefore, to sum it up: According to Rajasthan's NFHS-4 and NFHS-5 reports, there has been a significant increase in the state's coverage status. Despite the difficulties and the closure of the corona, this research will investigate the data that has demonstrated extraordinary rises and the causes that have made it possible or the huge efforts by the state government.

Financial worry in people with cancer: Relationship to employment and outcomes.

People with cancer experience financial hardship. Most previous research has focused on material financial burden rather than financial worry. This study investigated employment predictors of financial worry and examined outcomes potentially affected by financial worry. Data from the 2018 National Health Interview Study was used and limited to people diagnosed with cancer and having complete data on relevant variables (n=2049). Preliminary analyses indicated three dimensions of financial worry: healthcare; lifestyle; and basic needs. Outcomes included cost-related nonadherence, and presence of depressive symptoms and anxiety. Multivariable regressions examined the association of financial worry with cost-related nonadherence and mental health and employment characteristics (paid hourly; sick leave; employer size) with financial worry while controlling for demographics. Mean age was 68.10years (range: 20-85), and most had skin (33.6%), prostate (12.5%) or breast (21.4%) cancer. Hourly pay predicted more financial worry about affording healthcare (p<0.001), basic needs (p<0.001) and lifestyle (p<0.001). Having paid sick leave predicted less worry about basic needs (p=0.003). Worry about affording healthcare predicted more cost-related nonadherence (p<0.001) even when controlling for other variables associated with financial hardship. Worry about lifestyle (p=0.193) and basic needs (p=0.688) were not associated with cost-related nonadherence. Worry about lifestyle (p<0.001) predicted depression. Worry about affording healthcare (p=0.042) and lifestyle (p<0.001) predicted anxiety. Research is needed to determine the value of financial worry screening, particularly about affording healthcare, as well as material financial hardship. Financial worry should be included as an outcome in policy evaluations and interventions for financial hardship.

Sleep difficulties of sexual minority adults: Evidence from the 2018 National Health Interview Study.

Sleep difficulties of sexual minority adults: Evidence from the 2018 National Health Interview Study.

Prevalence of Psychological Distress Among Working-Age Adults in the United States, 1999-2018.

Objectives. To test whether the prevalence of reported psychological distress increased among working-age adults in the United States between 1999 and 2018. Methods. I examined psychological distress in the past 30 days using the Kessler-6 Distress Scale, completed by 403 223 participants aged 25 to 64 years across 20 annual waves of the National Health Interview Study conducted from 1999 to 2018. I examined overall and demographic-specific trends. Results. The prevalence of psychological distress in the past 30 days increased from 16.1% in 1999-2000 to 22.6% in 2017-2018, an increase of 6.5 percentage points (95% confidence interval [CI] = 5.6, 7.3) or 40% from 1999-2000 levels. Statistically significant increases in the prevalence of distress were observed across all age, gender, race/ethnicity, and educational attainment subgroups examined. Rates of serious psychological distress increased from 2.7% in 1999-2000 to 4% in 2017-2018, an increase of 1.3 percentage points (95% CI = 0.9, 1.6). Conclusions. Since 1999, there has been an upward trend in reported psychological distress among working-aged adults in the United States. (Am J Public Health. 2022;112(7):1045-1049. https://doi.org/10.2105/AJPH.2022.306828).

Current diagnosis and management of carpal tunnel syndrome: A review

Carpal tunnel syndrome (CTS) is a condition when median nerve, located in the carpal tunnel, is being suppressed by the surrounding structure. In 1854, the first clinical narration of median nerve compression in a carpal tunnel was found. CTS causes pain, tingling, and weakness in the half ring finger, middle finger, index finger, and thumb. These complaints lead the patients to seek medical help by a visiting doctor. CTS has become the major cause of upper extremity chronic neuropathic pain. CTS affects women 3.6 times more than men. This would cause high costs in medical treatment, rehabilitation, work hours lost compensation, initial pension costs, and new worker training. This makes CTS as a major problem in the field of employment. Carpal tunnel syndrome occurs as a result of chronic repetitive forceful work and other risk factors such as sex, age, heredity, hormonal, and weight. Knowledge of the diagnosis and comprehensive management of CTS are important to the doctor. Recent management based on the newest guidelines are important for clinician knowledge update. Correct diagnosis will lead to appropriate management based on recent CTS guidelines, which in turn will improve the quality of life for patients with CTS. This article will comprehensively discuss the diagnosis and recent management.
 Abbreviations: CTS - Carpal tunnel syndrome; NHIS - National Health Interview Study; EDX - Electrodiagnostic studies; SCT - Scratch Collapse Test; CSA - Cross-sectional area; PRP - Platelet-rich plasma; LLLT - Low-Level Laser Therapy; US – Ultrasound; DN - Dry needling; ECTR - Endoscopic carpal tunnel release; PDI - perineural dextrose injection; BCTQ - Boston Carpal Tunnel Questionnaire
 Key word: Carpal tunnel syndrome (CTS); neuropathy; pain; numbness; safe working environment; human; disease
 Citation: Hidayati HB, Subadi I, Fidiana, Puspamaniar VA. Current diagnosis and management of carpal tunnel syndrome: A review. Anaesth. pain intensive care 2022;26(3):394-404. DOI: 10.35975/apic.v26i3.1902
 Received: August 16, 2021; Reviewed: April 24, 2022; Accepted: April 28, 2022

Insurance status predicts self-reported influenza vaccine coverage among pregnant women in the United States: A cross-sectional analysis of the National Health Interview Study Data from 2012 to 2018

While the influenza vaccine is recommended for all pregnant women, influenza vaccine coverage among this high-risk population remains inadequate. Factors associated with vaccine coverage among pregnant women, including insurance status, are poorly understood. In a cross-sectional study of the National Health Interview Survey (NHIS) data from 2012 to 2018, we evaluated predictors of self-reported influenza vaccine coverage in pregnant women. Among 1,942 pregnant women surveyed, 39% reported receiving the influenza vaccine in accordance with national recommendations. Influenza vaccine coverage increased by 8 percentage points from 2012 to 2018. Only 15% of uninsured pregnant women received the influenza vaccine, compared to 41% of those with insurance (design-corrected F-test, p-value < 0.001). In the multivariate Poisson regression analysis, significant predictors of influenza vaccine coverage were health insurance (prevalence ratio [PR] 1.90, 95% confidence interval [CI] 1.23–2.93), ratio of household income to federal poverty level (FPL) threshold greater than 400% (PR 1.54, 95% CI 1.20–1.96), graduate school education (PR 1.52, 95% CI 1.04–2.23), and the 2015–2018 survey year period (PR 1.27, 95% CI 1.08–1.49). While previous literature focuses heavily on demographics, our research underscores the need to further explore modifiable factors that impact vaccine uptake during pregnancy, particularly the interplay between health insurance and access to care.

Factors Related to Carpal Tunnel Syndrome (CTS) Complaints on Employees in the Bank BNI Branch of Palu

Carpal Tunnel Syndrome (CTS) is a disorder that occurs due to carpal tunnel or a gap in the lower hand to the wrist narrowing. The National Health Interview Study (NHIS) estimates that the reported prevalence of CTS among the adult population is 1.55% (2.6 million). This research was conducted at BNI Branch Bank Palu. The research objective is to determine the factors associated with complaints of Carpal Tunnel Syndrome (CTS) on employees at BNI Branch Bank Palu. The type of research used is quantitative using a cross-sectional approach. The number of samples was 109 people. Data were analyzed using the chi-square test at the level of confidence (ρ &lt;0.05). The results showed that there was a relationship between years of service (ρ = 0.005), length of work (ρ = 0,000), repetitive movements (ρ = 0.001) and gender (ρ = 0.006) with complaints of Carpal Tunnel Syndrome (CTS) on employees at the Bank BNI Palu Branch. It is recommended to employees of Bank BNI Branch Palu to do muscle stretches such as moving the fingers, reducing the emphasis on the carpal tunnel, to avoid the danger of disturbances originating from repetitive and monotonous movements in the long term.

ESPO AND NIA BUTLER-WILLIAMS SCIENTIFIC SYMPOSIUM: INFLUENCE OF RACE, ETHNICITY, AND EXPERIENCE ON HEALTH IN AGING

The NIA’s Butler-Williams Scholars Program and GSA’s Emerging Scholars and Professional Organization are united in providing career development opportunities for early career scholars in a manner that promotes leadership, diversity, and inclusivity. This provides a foundation to develop a network of next generation of scientists, clinicians, and policy makers capable of shaping health in aging. Among the chief concerns of our aging population are disparities in health associated with race/ethnicity, experience, environment, access to health care, and sociocultural and socioeconomic factors. GSA’s early career professionals and alumni of the prestigious NIA Butler-Williams Scholars Program have tackled these issues directly and the scientific scholarship that results is astounding in its breadth and depth. Dr. Vicki Johnson-Lawrence, Ph.D. (Butler-Williams class of 2014), will present on the interacting effects of education and race/ethnicity on multi-morbidity, highlighting lessons learned from the National Health Interview Study. Dr. Lauren Parker (Butler-Williams class of 2018) will review efforts to develop culturally competent content for recruitment of Hispanic and black/African American persons to NIA-supported dementia-caregiving studies. Dr. Ryon Cobb (Butler-Williams class of 2016) will discuss the impact of race/ethnicity on kidney function among older adults, with evidence from the Health and Retirement Study. The final speaker, Dr. Ana Quiñones (Butler-Williams class of 2012), will present on longitudinal tracking of multi-morbidity in racially/ethnically diverse older adults. In sum, the featured talks by rising stars in aging research deepen our understanding of the influence of race, ethnicity, and experience on health and chronic disease in diverse aging populations.

Self-Reported Oral Health Status Among Adults Aged 40+ Years With and Without Vision Impairment: National Health Interview Study, 2008

To examine self-reported oral health among adults aged 40 years and older with and without vision impairment. Cross-sectional, with a nationally representative sample. We used publicly available data from the Oral Health Module, last administered in 2008, of the National Health Interview Survey. Outcome variables included fair/poor oral health status, mouth condition compared to others the same age, mouth problems (mouth sores, difficulty eating, dry mouth, bad breath, and/or jaw pain), teeth problems (toothache; broken/missing fillings or teeth; loose, crooked, or stained teeth; and/or bleeding gums), and lack of social participation. Using descriptive statistics and multivariate logistic regression, we examined the association (P < .05) between vision impairment and oral health outcomes by age group, sociodemographics, and other explanatory variables. Our study sample included 12,090 adults; 12.8% of adults aged 40-64 years reported vision impairment, and among them, 44.5% reported fair/poor oral health status and 47.2% reported any mouth problems. Among adults aged ≥65 years, 17.3% reported vision impairment, of whom 36.3% reported fair/poor oral health status and 57.3% reported any mouth problems. There is a strong association between vision impairment and poorer oral health of adults; adults aged 40-64 years with vision impairment reported 90%-150% greater odds of oral health problems, including fair/poor oral health status, mouth problems, and teeth problems, compared to people without vision impairment. Oral health disparities exist between adults with and without vision impairment. Targeted interventions are required to improve oral health in this vulnerable population.

Food Insecurity and Child Health

Food insecurity is an important public health problem facing children in the United States. Although a number of previous studies suggest that food insecurity has negative impacts on health, these studies have not dealt thoroughly with issues of selection bias. We use propensity scoring techniques to approximate the causal effects of food insecurity on children's health and health care use outcomes. We use nationally representative data from the 2013-2016 waves of the National Health Interview Study (N = 29 341). Using inverse probability of treatment weighting, a propensity scoring method, we examine a broad range of child health outcomes and account for a comprehensive set of controls, focusing on a sample of children 2 to 17 years old. Household food insecurity was related to significantly worse general health, some acute and chronic health problems, and worse health care access, including forgone care and heightened emergency department use, for children. Compared to rates had they not been food insecure, children in food-insecure household had rates of lifetime asthma diagnosis and depressive symptoms that were 19.1% and 27.9% higher, rates of foregone medical care that were 179.8% higher, and rates of emergency department use that were 25.9% higher. No significant differences emerged for most communicable diseases, such as ear infections or chicken pox, or conditions that may develop more gradually, including anemia and diabetes. Policies used to reduce household food insecurity among children may also reduce children's chronic and acute health problems and health care needs.