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More kids are getting wellness checkups, but big gaps remain

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For decades, pediatricians have recommended a regular schedule of well-child visits — to check on children’s growth, development and health, and offer parents the chance to talk with their children’s doctor, catch kids up on scheduled vaccinations and more.

Now, a study in JAMA Pediatrics sheds light on both growth and inequality in well-child visits. The check-ins are associated with better health outcomes, fewer hospitalizations and emergency room visits, and improved provider-parent communication.

Health and Human Services researchers at the Agency for Healthcare Research and Quality analyzed data from more than 36,500 children documented in the Medical Expenditure Panel Survey, an ongoing nationwide survey on who uses health care in the United States. To track whether visit compliance had grown, they compared data from 2006 and 2007 to 2016 and 2017.

The researchers found that 14.5 percent more kids completed their recommended well-child checkups in 2016 and 2017, raising the number of children in compliance from 47.9 percent to 62.3 percent.

But that growth was far from equal. When the researchers dove into the data, they found that non-White children trailed their counterparts in well-child visits. About 68 percent of White, non-Hispanic children were compliant in 2016 and 2017, compared with 52.5 percent of Black children and 58 percent of Hispanic children.

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Not surprisingly, insured status mattered. Though adherence levels rose more for kids covered by public insurance and kids without insurance coverage, only 31 percent of children who weren’t insured made the recommended visits in 2016 and 2017.

While 67.6 percent of children whose parents had attended college went to their well-child checkups, about 50 percent of children whose parents did not complete high school didn’t get checked up on schedule.

There were regional gaps, too: Some 79.3 percent of kids from the Northeast made it to the recommended visits, but only 65.3 percent of children in the Midwest, 58.2 percent in the South and 55.2 percent in the West did the same.

To correct the imbalance, the researchers write, policymakers and medical professionals must work to improve both access and professional engagement in marginalized communities.

Although researchers are still working to understand why parents skip well-child visits, factors such as work, transportation and patient education are thought to play a role.

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