A new report on mothers with young children enrolled in Medicaid finds that while generally pleased with the overall care their sons and daughters receive, many mothers feel that the program-as well as pediatricians-could do a better job of providing guidance on early development.
For the report, Child Development and Medicaid: Attitudes of Mothers with Young Children Enrolled in Medicaid, the health policy consulting group Lake Snell Perry & Associates conducted eight focus groups with mothers of Medicaid-enrolled children in North Carolina, Utah, Vermont, and Washington.
According to authors Susan Kannel and Michael Perry, poverty places children at risk for an array of health and developmental problems. Children of low-income families are less likely to have access to health care, and their parents are less likely to engage in activities that can foster their child's physical and intellectual growth, such as breast-feeding and reading aloud on a daily basis. By providing families with nurse home-visiting programs, structured developmental assessments, and parenting guidance, Medicaid and other programs can play an important role in these children's lives.
Mothers who participated in the discussions talked about the barriers they face in obtaining information about child development. Many of them do not have a regular pediatrician with whom they can develop a relationship--one who will engage them in a real discussion about their infant or toddler's growth. Moreover, many mothers have an incomplete understanding of well-child care; some believe that regular immunizations are all their child requires. Participants also complained that their child's pediatrician does not spend enough time with them.
Even mothers who said they have adequate access to information on child development often expressed dissatisfaction with the way that information is presented to them. Participants said doctors simply tell them what to do without listening to their views and showing respect for their sometimes years of child-rearing experience. When doctors or nurses treat them this way, some women said it becomes harder to accept and follow their advice.
The project was commissioned by The Commonwealth Fund as part of its ABCD initiative to expand low-income families' access to developmental services. The four states (NC, UT, VT, and WA) were each awarded grants to enhance their Medicaid program's capacity to provide such services.
Facts and Figures
- About one of five (22%) children age 5 and under lives in a family with income at or below the poverty level, which is about $17,000 for a family of four.
- State Medicaid programs serve one-quarter of all U.S. children age 6 and under and 61 percent of poor children ages 1 to 6.
- Poor children are more likely to have a low birth weight, be overweight toddlers, get lead poisoning, experience developmental delay, have a learning disability, or suffer from emotional or behavioral problems.
