Research has shown that children and adolescents in the United States are less healthy than their counterparts in other high-income countries. But it’s not clear to what extent this disadvantage stems from poverty, lack of access to medical care, or other factors. To better understand the influence of one variable—household income—on health care use, former Commonwealth Fund Harkness Fellow Dougal Hargreaves and colleagues compared health care utilization rates for children and adolescents in the U.S. with those in the Netherlands, which ranks near the top of countries in child health and well-being.
What the Study Found
- On average, U.S. children and adolescents had around half the medical and dental care episodes their Dutch peers had. The differences were most pronounced among low-income children and adolescents.
- Within the U.S., children and adolescents in the lowest-income quartile had fewer doctor and dental contacts than those in the top income quartile. In the Netherlands, the reverse was true: children and adolescents in the poorest families reported more doctor contacts than those in the wealthiest families.
- The authors found no significant difference in the number of doctor and dental contacts across the poorest three–fifths of families in the U.S. This suggests that infrequent contact with doctors and dentists is not confined to the poorest quintile of households in the U.S.
The data suggest there may be significant levels of unmet health care need across the U.S. pediatric population. Additional research is needed to explore related factors, which may include lack of access to providers, the quality of services, and parental attitudes.