America's Children in Brief: Key National Indicators of Well-Being, 2012

Health Care

Health care includes the prevention, treatment, and management of illness and the promotion of emotional, behavioral, and physical well-being. Effective health care is an important aspect of achieving good health outcomes. Health insurance status and usual source of health care affect whether care is received and the type of care provided. The receipt of immunization and dental visits characterize care utilization.

Children with health insurance, whether public or private, are more likely than children without insurance to have regular access to health care. In 2010, 90 percent of children had health insurance coverage at least some time during the year,¹⁰ not statistically different from 2009 (Figure 6). The number of children without coverage at least some time during the year was 7.3 million (10 percent of all children). The percentage of children who were covered by public health insurance at least some time during the year increased from 37 percent in 2009 to 38 percent in 2010. The percentage of children covered by private health insurance at least some time during the year in 2010 was 60 percent, down from 61 percent in 2009.

Figure 6: Percentage of children ages 0–17 covered by health insurance at some time during the year by type of health insurance, 1987–2010

Having a usual source of care—a particular person or place a child goes to for sick and preventive care—allows access to the timely and appropriate use of pediatric services.^{11, 12} In 2010, 5 percent of children ages 0–17 had no usual source of health care; this was no different from the percentage in 2009. Children who were uninsured were about 4 times as likely as those with health insurance not to have a usual source of care in 2010 (29 percent compared with about 7 percent).

Vaccination coverage rates measure the extent to which children and adolescents are being protected from vaccine-preventable diseases. A single dose of the tetanus, diphtheria, pertussis (Tdap) vaccine is recommended at age 11 or 12. Vaccination coverage with 1 dose (or more) of the Tdap vaccine for ages 13–17 increased from 11 percent in 2006 to 69 percent in 2010 (Figure 7). The meningococcal conjugate (MenACWY) vaccine prevents a serious bacterial illness and is a leading cause of meningitis. Two doses are recommended for adolescents: the first at age 11 or 12 and a second at age 16. Coverage with 1 dose (or more) of the MenACWY vaccine increased from 12 percent in 2006 to 63 percent in 2010. The human papillomavirus (HPV) vaccine protects against the most common sexually transmitted virus, which can cause cervical cancer in women. Three doses of the HPV vaccine have been routinely recommended for adolescent females ages 11–12. The percentage of adolescent females ages 13–17 initiating the HPV series with 1 dose or more increased from 25 percent in 2007 to 49 percent in 2010, and for those receiving 3 doses or more of the HPV series increased from 18 percent in 2008 to 32 percent in 2010.

Figure 7: Percentage of adolescents ages 13–17 with the routinely recommended-for-age vaccinations, 2006–2010

Good oral health requires both self-care and professional care. In 2010, 85 percent of children ages 5–17 had a dental visit in the past year, unchanged from 2009. Among children ages 5–17 in poverty, 79 percent had a dental visit in the past year, compared with 90 percent of children ages 5–17 with family incomes 200 percent or more of the poverty level. Fifty-six percent of uninsured children ages 5–17 had a dental visit in the past year, compared with 85 percent of children ages 5–17 with public and 90 percent with private health insurance. In 2010, children ages 2–4 were less likely to have had a dental visit in the past year (52 percent) than children ages 5–17 (85 percent).