Socioeconomic disparities and difficulties to access to healthcare services among Canadian children with neurodevelopmental disorders and disabilities.
- Author:
Sana RAOUAFI
1
;
Sofiane ACHICHE
;
Maxime RAISON
Author Information
- Publication Type:Original Article
- Keywords: Neurodevelopmental disorders; Children with disabilities; Socioeconomic status; Inequalities
- MeSH: Canada; Child*; Delivery of Health Care*; Disabled Children; Family Characteristics; Health Expenditures; Health Personnel; Health Services; Humans; Interpersonal Relations; Logistic Models; Neurodevelopmental Disorders*; Public Policy; Sample Size; Social Class; Social Work; Social Workers; Socioeconomic Factors
- From:Epidemiology and Health 2018;40(1):e2018010-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVES: The aims of this study were to identify the associations of levels of severity of neurodevelopmental disorders and disabilities (NDD/D) in children with their household socioeconomic status (SES) and their frequency of visits to a healthcare provider, and to examine how the severity of disability varied with these determinants among NDD/D subgroups, in order to inform possible social policy changes and to improve access to the healthcare system. METHODS: Data from the 2006 Participation and Activity Limitation Survey on children aged 5-14 years, collected by Statistics Canada, were analyzed (n=7,072 and weighted n=340,340). Children with NDD/D constituted those with impairments in motor, speech, neurosensory, and psychological functioning, as well as those who had issues with learning/cognition and social interactions. The weighted sample size for this group was n=111,630 (total sample size for children with limitations: n=174,810). We used logistic regression to assess the associations of household SES and frequency of visits to a healthcare provider with disability level. We included NDD/D subgroups as interaction terms in the model. Multiple correspondence analysis (MCA) was conducted to develop a profile of disability level. RESULTS: After-tax low income, family assistance, out-of-pocket expenses, needing but not receiving health services from a social worker, condition of the dwelling, and residential location were associated with the severity of NDD/D. Using MCA, 2 disability profiles could be identified based on access to healthcare, household income status, and condition of the dwelling. CONCLUSIONS: More social interventions are needed to reduce difficulties in accessing healthcare and to diminish the socially determined health inequalities faced by children with NDD/D.
