Carolyn C Foster1,2, Anna Chorniy3,4,5, Soyang Kwon6,2, Kristin Kan6,2, Nia Heard-Garris6,5,2, Matthew M Davis6,3,7,2. 1. Division of Advanced General Pediatrics and Primary Care, Departments of Pediatrics ccfoster@luriechildrens.org. 2. Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 3. Medical Social Sciences. 4. Buehler Center for Health Policy and Economics, Feinberg School of Medicine. 5. Institute for Policy Research, Northwestern University, Chicago, Illinois. 6. Division of Advanced General Pediatrics and Primary Care, Departments of Pediatrics. 7. Medicine and Preventive Medicine.
Abstract
BACKGROUND: Family income is known to affect child health, but this relationship can be bidirectional. We sought to characterize this relationship by quantifying forgone family employment (FFE) due to a child's health condition in families of children with special health care needs (CSHCN) with updated figures. METHODS: We conducted a secondary data analysis from the 2016-2017 National Survey of Children's Health. CSHCN with previously employed caregivers were included (N = 14 050). FFE was defined as any family member having stopped work and/or reduced hours because of their child's health or health condition. Child, caregiver, and household characteristics were compared by FFE status. Logistic regression analysis was conducted to evaluate the association between hours of medical care provide by a family member and FFE. US Bureau of Labor Statistics reports were used to estimate lost earnings from FFE. RESULTS: FFE occurred in 14.5% (95% confidence interval [CI] 12.9%-16.1%) of previously employed families with CSHCN and was 40.9% (95% CI 27.1%-54.7%) for children with an intellectual disability. We observed disproportionately high FFE among CSHCN who were 0 to 5 years old and of Hispanic ethnicity. We found a strong association between FFE and increasing hours of family-provided medical care, with an adjusted odds ratio (aOR) of 1.72 (95% CI 1.25-2.36) for <1 hour per week (compared with 0 hours), an aOR of 5.96 (95% CI 4.30-8.27) for 1 to 4 hours per week, an aOR of 11.89 (95% CI 6.19-22.81) for 5 to 10 hours per week, and an aOR of 8.89 (95% CI 5.26-15.01) for >10 hours per week. Lost earnings for each household with FFE were estimated at ∼$18 000 per year. CONCLUSIONS: With our findings, we highlight the need to implement programs and policies that address forgone income experienced by families of CSHCN.
BACKGROUND: Family income is known to affect child health, but this relationship can be bidirectional. We sought to characterize this relationship by quantifying forgone family employment (FFE) due to a child's health condition in families of children with special health care needs (CSHCN) with updated figures. METHODS: We conducted a secondary data analysis from the 2016-2017 National Survey of Children's Health. CSHCN with previously employed caregivers were included (N = 14 050). FFE was defined as any family member having stopped work and/or reduced hours because of their child's health or health condition. Child, caregiver, and household characteristics were compared by FFE status. Logistic regression analysis was conducted to evaluate the association between hours of medical care provide by a family member and FFE. US Bureau of Labor Statistics reports were used to estimate lost earnings from FFE. RESULTS: FFE occurred in 14.5% (95% confidence interval [CI] 12.9%-16.1%) of previously employed families with CSHCN and was 40.9% (95% CI 27.1%-54.7%) for children with an intellectual disability. We observed disproportionately high FFE among CSHCN who were 0 to 5 years old and of Hispanic ethnicity. We found a strong association between FFE and increasing hours of family-provided medical care, with an adjusted odds ratio (aOR) of 1.72 (95% CI 1.25-2.36) for <1 hour per week (compared with 0 hours), an aOR of 5.96 (95% CI 4.30-8.27) for 1 to 4 hours per week, an aOR of 11.89 (95% CI 6.19-22.81) for 5 to 10 hours per week, and an aOR of 8.89 (95% CI 5.26-15.01) for >10 hours per week. Lost earnings for each household with FFE were estimated at ∼$18 000 per year. CONCLUSIONS: With our findings, we highlight the need to implement programs and policies that address forgone income experienced by families of CSHCN.
Authors: James M Perrin; Christina F Fluet; Lynda Honberg; Betsy Anderson; Nora Wells; Susan Epstein; Deborah Allen; Carol Tobias; Karen A Kuhlthau Journal: Health Aff (Millwood) Date: 2007 Jul-Aug Impact factor: 6.301
Authors: Barbara S Saunders; J Mick Tilford; Jill J Fussell; Eldon G Schulz; Patrick H Casey; Dennis Z Kuo Journal: Fam Syst Health Date: 2015-01-12 Impact factor: 1.950
Authors: Paul J Chung; Craig F Garfield; Marc N Elliott; Colleen Carey; Carl Eriksson; Mark A Schuster Journal: Pediatrics Date: 2007-05 Impact factor: 7.124
Authors: Michael D Hurd; Paco Martorell; Adeline Delavande; Kathleen J Mullen; Kenneth M Langa Journal: N Engl J Med Date: 2013-04-04 Impact factor: 91.245
Authors: Chris Feudtner; Russell T Nye; Jackelyn Y Boyden; Katherine E Schwartz; Emilie R Korn; Aaron G Dewitt; Amy T Waldman; Lisa A Schwartz; Yuming A Shen; Michael Manocchia; Rui Xiao; Blyth T Lord; Douglas L Hill Journal: JAMA Netw Open Date: 2021-12-01