Parent's language of interview and access to care for children with special health care needs

Objective.-To examine the association between the parent's language of interview and the access to care for children with special health care needs (CSHCN). Methods.-We used the 2001 National Survey of Children with Special Health Care Needs to compare socio-demographic characteristics and health care access variables among CSHCN with parents who interviewed in English and another language. Additional multivariate analyses explored the effect of language of interview on access to health care for the subgroup of Hispanic respondents. Results.-CSHCN with non-English-speaking parents were from less-educated and lower-income families and were more likely to lack insurance and have conditions that greatly affected their activities. These children were also more likely to have inadequate insurance (odds ratio [OR] - 11.29), have an unmet need for family support services (OR 1.88), lack a personal doctor or nurse (OR = 1.98), lack a usual source of care (OR = 1.89), and lack family-centered care (OR = 1.74). Non-English-speaking parents were more likely to report having employment consequences (OR = 1.94) and spending over $500 out-of-pocket annually on the child's health care needs (OR = 1.49). The likelihood of Hispanic children experiencing health care access barriers compared with non-Hispanic children was reduced when language was controlled for and several disparities between Hispanic children and other children became insignificant. Conclusions.-CSHCN with non-English-speaking parents were more likely to be from disadvantaged families and to experience barriers to access than were CSHCN with English-speaking parents. Systems of care for CSHCN should consider the needs and challenges experienced by families whose primary language is not English.