Children with Special Health Care Needs

Key facts about children and youth with special health care needs

  • In 2016, about one in five children and adolescents (19 percent) had a special health care need, as reported by their parents.
  • One in four non-Hispanic black children and youth (25 percent) have special health care needs, as reported by their parents, which is 5 to 15 percentage points more than any other major racial or ethnic group.
  • The proportion of children and youth with special health care needs who have publicly funded health insurance has nearly doubled from 2001 to 2016, from 22 to 41 percent.

Trends for children and youth with special health care needs

Since 2001, the proportion of children and youth reported to have special health care needs has been steadily rising. From 2001 to 2016, the percentage of children and youth with special health care needs has increased from 13 to 19 percent.

Differences by gender

A higher percentage of male children and youth have special health care needs, as reported by their parents, relative to female children and youth. In 2016, 22 percent of males under 18 had special health care needs, compared with 17 percent of females.

Differences by race/Hispanic origin[1]

In 2016, the proportion of children and youth with special health care needs varied by race and Hispanic origin. According to parents’ reports, non-Hispanic black children and youth were the most likely to have special health care needs (25 percent), followed by non-Hispanic white and Native American/Alaskan Native children and youth (each at 20 percent). A lower percentage of Hispanic children and youth have special health care needs, but the reported prevalence among this group rose between 2009–2010 and 2016, from 11 to 17 percent. Non-Hispanic Asian children and youth were the least likely to have special health care needs, at 10 percent. (Figure 2).

Differences by age

In 2016, more children and youth in the 6–11 and 12–17 age groups were reported as having special health care needs (23 and 24 percent, respectively) than those in the birth to 5 age group (11 percent). Some of this disparity results from the 12–17 age group including children and youth for which special heath care needs have been identified at later ages.

Differences by poverty level

In 2016, a higher proportion of children and youth whose parents reported living in poverty had special health care needs, compared with those whose parents reported having incomes of at least 200 percent of the poverty line (23 and 18 percent, respectively) (Appendix 1).

State and local estimates

The Data Resource Center for Child & Adolescent Health website allows users to generate state-level estimates from the 2016 National Survey of Children’s Health, as well as the 2001, 2005–2006, and 2009–2010 National Surveys of Children with Special Health Care Needs. Users can select desired variables and subgroup breakdowns, by age, gender, race/ethnicity, and other characteristics, to generate customized tables or figures. This data tool is available here.

The National Survey of Children with Special Health Care Needs Chartbooks include state profiles of children and youth with special health care needs. Each profile includes the total number of children and youth with special health care needs for that state, as well as state-level estimates for related indicators. The chartbooks are available at these links:

State-level estimates of children and youth with special health care needs are also available at the KIDS COUNT Data Center.

Data and appendices

Data source

Data for 2016: Child Trends’ original analyses of data using U.S. Department of Health and Human Services, Maternal and Child Health Bureau. (2017). 2016 National Survey of Children’s Health [Dataset]. Retrieved from https://www.census.gov/programs-surveys/nsch.html.

Data for 2001–2010: Child Trends’ original analyses of data using U.S. Department of Health and Human Services, National Center for Health Statistics. (2002–2011). National Survey of Children with Special Health Care Needs, 2001, 2005–2006, and 2009–2010 [Dataset]. Retrieved from https://www.cdc.gov/nchs/slaits/cshcn.htm.

Raw data source

National Survey of Children with Special Health Care Needs:

http://www.cdc.gov/nchs/slaits/cshcn.htm

National Survey of Children’s Health:

https://www.census.gov/programs-surveys/nsch.html

Appendices

Appendix 1

Appendix 2

Background

Definition

To establish the presence of children or youth with special health care needs, the National Survey of Children’s Health (2016) and National Survey of Children with Special Health Care Needs (2001, 2005–2006, 2009–2010) asked parents the following questions:

  • Does the child currently need or use medicine prescribed by a doctor, other than vitamins?
  • Does the child need or use more medical care, mental health, or educational services than is usual for most children of the same age?
  • Is the child limited or prevented in any way in his or her ability to do the things most children of the same age can do?
  • Does the child need or get special therapy, such as physical, occupational, or speech therapy?
  • Does the child have any kind of emotional, developmental, or behavioral problem for which he or she needs treatment or counseling?

In follow-up after each question, parents were asked whether the condition was expected to last for 12 months or longer, and whether the condition was due to any medical, behavioral, or other health condition. If the answer to one (or more) of the conditions was “yes,” and the answers to both follow-up questions for the condition(s) were also “yes,” then the child was considered to have special health care needs.


Endnotes

[1] Hispanic children may be of any race.