Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 1/2012

01-04-2012

Measuring the Impact of Hurricane Katrina on Access to a Personal Healthcare Provider: The Use of the National Survey of Children’s Health for an External Comparison Group

Authors: Tasha Stehling-Ariza, Yoon Soo Park, Jonathan J. Sury, David Abramson

Published in: Maternal and Child Health Journal | Special Issue 1/2012

Login to get access

Abstract

This paper examined the effect of Hurricane Katrina on children’s access to personal healthcare providers and evaluated the use of propensity score methods to compare a nationally representative sample of children, as a proxy for an unexposed group, with a smaller exposed sample. 2007 data from the Gulf Coast Child and Family Health (G-CAFH) Study, a longitudinal cohort of households displaced or greatly impacted by Hurricane Katrina, were matched with 2007 National Survey of Children’s Health (NSCH) data using propensity score techniques. Propensity scores were created using poverty level, household educational attainment, and race/ethnicity, with and without the addition of child age and gender. The outcome was defined as having a personal healthcare provider. Additional confounders (household structure, neighborhood safety, health and insurance status) were also examined. All covariates except gender differed significantly between the exposed (G-CAFH) and unexposed (NSCH) samples. Fewer G-CAFH children had a personal healthcare provider (65 %) compared to those from NSCH (90 %). Adjusting for all covariates, the propensity score analysis showed exposed children were 20 % less likely to have a personal healthcare provider compared to unexposed children in the US (OR = 0.80, 95 % CI 0.76, 0.84), whereas the logistic regression analysis estimated a stronger effect (OR = 0.28, 95 % CI 0.21, 0.39). Two years after Hurricane Katrina, children exposed to the storm had significantly lower odds of having a personal health care provider compared to unexposed children. Propensity score matching techniques may be useful for combining separate data samples when no clear unexposed group exists.
Literature
1.
2.
Fisher, E. S. (2008). Building a medical neighborhood for the medical home. New England Journal of Medicine, 359(12), 1202–1205.PubMedCrossRef
3.
Ad Hoc Task Force on Definition of the Medical Home. (1992). The medical home. Pediatrics, 90(5), 774.
4.
Sia, C., et al. (2004). History of the medical home concept. Pediatrics, 113(5 Suppl), 1473–1478.PubMed
5.
Mason, J. O., & Mcginnis, J. M. (1990). Healthy people 2000: An overview of the national-health promotion and disease prevention objectives. Public Health Reports, 105(5), 441–446.PubMed
6.
7.
8.
Homer, C. J., et al. (2008). A review of the evidence for the medical home for children with special health care needs. Pediatrics, 122(4), e922–e937.PubMedCrossRef
9.
Sheldrick, R. C. (2010). Medical home services for children with behavioral health conditions. Journal of Developmental and Behavioral Pediatrics, 31(2), 92–99.PubMedCrossRef
10.
Starfield, B., & Shi, L. (2004). The medical home, access to care, and insurance: A review of evidence. Pediatrics, 113(5 Suppl), 1493–1498.PubMed
11.
Strickland, B., et al. (2004). Access to the medical home: Results of the National Survey of Children with special health care needs. Pediatrics, 113(5 Suppl), 1485–1492.PubMed
12.
Elster, A., et al. (2003). Racial and ethnic disparities in health care for adolescents: A systematic review of the literature. Archives of Pediatrics and Adolescent Medicine, 157(9), 867–874.PubMedCrossRef
13.
Flores, G., Olson, L., & Tomany-Korman, S. C. (2005). Racial and ethnic disparities in early childhood health and health care. Pediatrics, 115(2), E183–E193.PubMedCrossRef
14.
Flores, G., & Tomany-Korman, S. C. (2008). Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics, 121(2), E286–E298.PubMedCrossRef
15.
Halfon, N., Inkelas, M., & Wood, D. (1995). Nonfinancial barriers to care for children and youth. Annual Review of Public Health, 16, 447–472.PubMedCrossRef
16.
Newacheck, P. W., Hughes, D. C., & Stoddard, J. J. (1996). Children’s access to primary care: Differences by race, income, and insurance status. Pediatrics, 97(1), 26–32.PubMed
17.
Seid, M., Stevens, G. D., & Varni, J. W. (2003). Parents’ perceptions of pediatric primary care quality: Effects of race/ethnicity, language, and access. Health Services Research, 38(4), 1009–1031.PubMedCrossRef
18.
Shi, L., & Stevens, G. D. (2005). Disparities in access to care and satisfaction among U.S. children: the roles of race/ethnicity and poverty status. Public Health Reports, 120(4), 431–441.PubMed
19.
Stevens, G. D. (2010). National disparities in the quality of a medical home for children. Mater Child Health Journal, 14(4), 580–589.CrossRef
20.
Stevens, G. D., & Shi, L. (2003). Racial and ethnic disparities in the primary care experiences of children: A review of the literature. Medical Care Research and Review, 60(1), 3–30.PubMedCrossRef
21.
Strickland, B. B., et al. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604–611.PubMedCrossRef
22.
Leus, X., Wallace, J., & Loretti, A. (2001). Internally displaced persons. Prehospital and Disaster Medicine, 16(3), 116–123.PubMed
23.
Norwegian Refugee Council and Internal Displacement Monitoring Centre. (2007). Internal displacement: Global overview of trends and developments. In: J.-H. Esbenbacher & A. Glusker (Eds.), (pp 1–103). Geneva: Norwegian Refugee Council.
24.
Vest, J. R., & Valadez, A. M. (2006). Health conditions and risk factors of sheltered persons displaced by Hurricane Katrina. Prehospital and Disaster Medicine, 21(2), 55–58.PubMed
25.
26.
27.
Brodie, M., et al. (2006). Experiences of Hurricane Katrina evacuees in Houston shelters: Implications for future planning. American Journal of Public Health, 96(8), 1402–1408.PubMedCrossRef
28.
Liu, A. (2008). The New Orleans index: Tracking the recovery of New Orleans and the metro area. Washington, DC: The Brookings Institution.
29.
Madrid, P. A. A. (2008). Building integrated mental health and medical programs for vulnerable populations post-disaster: Connecting children and families to a medical home. Prehospital and Disaster Medicine, 23(4), 314–321.PubMed
30.
31.
Abramson, D., Redlener, I., Stehling-Ariza, T., & Fuller, E. (2007). The legacy of Katrina’s children: Estimating the numbers of at-risk children in the Gulf Coast States of Louisiana and Mississippi. NCDP Research Brief 2007_12. New York: National Center for Disaster Preparedness, Mailman School of Public Health, Columbia University. Available at: http://​hdl.​handle.​net/​10022/​AC:​P:​8845. Accessed 6 Aug 2010.
32.
Abramson, D. M., et al. (2010). Children as bellwethers of recovery: Dysfunctional systems and the effects of parents, households, and neighborhoods on serious emotional disturbance in children after Hurricane Katrina. Disaster Medicine and Public Health Preparedness, 4(Supplement_1), S17–S27.CrossRef
33.
Weisler, R. H., Barbee, J. G., & Townsend, M. H. (2006). Mental health and recovery in the Gulf Coast after Hurricanes Katrina and Rita. JAMA, the Journal of the American Medical Association, 296(5), 585–588.CrossRef
34.
D’Agostino, R. B. (1998). Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Statistics in Medicine, 17(19), 2265–2281.PubMedCrossRef
35.
Guo, S., & Fraser, M. (2010). Propensity score analysis: Statistical methods and applications. Thousand Oaks, CA: Sage.
36.
Imbens, G. (2000). The role of propensity score in estimating dose-response functions. Biometrika, 87(3), 706–710.CrossRef
37.
Joffe, M. M., & Rosenbaum, P. R. (1999). Invited commentary: Propensity scores. American Journal of Epidemiology, 150(4), 327–333.PubMedCrossRef
38.
Oakes, J. M., & Johnson, P. J. (2006). Propensity score matching for social epidemiology. In J. Oakes & J. Kaufman (Eds.), Methods in social epidemiology (pp. 370–392). San Francisco: Jossey-Bass/Wiley.
39.
Rosenbaum, P. R. (2002). Observational studies (2nd ed.). New York: Springer.
40.
Rubin, D. B. (1997). Estimating causal effects from large data sets using propensity scores. Annals of Internal Medicine, 127(8), 757–763.PubMed
41.
Rubin, D. B., & Thomas, N. (1996). Matching using estimated propensity scores: Relating theory to practice. Biometrics, 52(1), 249–264.PubMedCrossRef
42.
Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41–55.CrossRef
43.
Rosenbaum, P. R., & Rubin, D. B. (1984). Reducing bias in observational studies using subclassification on the propensity score. Journal of the American Statistical Association, 79, 516–524.
44.
Abramson, D., & Garfield, R. (2006). On the edge: Children and families displaced by Hurricanes Katrina and Rita face a looming medical and mental health crisis. New York City: National Center for Disaster Preparedness.
45.
Abramson, D., Garfield, R., & Redlener, I. (2007). The recovery divide: Poverty and the widening gap among Mississippi children and families affected by Hurricane Katrina. New York City: National Center for Disaster Preparedness.
46.
Abramson, D., et al. (2008). Prevalence and predictors of mental health distress post-Katrina: Findings from the Gulf Coast Child and Family Health Study. Disaster Medicine and Public Health Preparedness, 2(2), 77–86.PubMedCrossRef
47.
Kish, L. (1965). Survey sampling. New York: Wiley.
48.
49.
50.
51.
Stebbins, H., & Knitzer, J. (2007). State early childhood policies: Highlights from the improving the odds for young children project. New York, NY: National Center for Children in Poverty.
52.
Zinth, K. (2005). What governors need to know: Highlights of state education systems. Denver, CO: Education Commission of the States.
53.
DeCoster, J., Iselin, A.-M. R., & Gallucci, M. (2009). A conceptual and empirical examination of justifications for dichotomization. Psychological Methods, 14(4), 349–366.PubMedCrossRef
54.
Cohan, C. L., Cole, S. W., & Schoen, R. (2009). Divorce following the September 11 terrorist attacks. Journal of Social and Personal Relationships, 26(4), 512–530.CrossRef
55.
Hawkins, R. L., & Maurer, K. (2011). ‘You fix my community, you have fixed my life’: The disruption and rebuilding of ontological security in New Orleans. Disasters, 35(1), 143–159.PubMedCrossRef
56.
Rudowitz, R., Rowland, D., & Shartzer, A. (2006). Health care in New Orleans before and after Hurricane Katrina. Health Affairs, 25(5), W393–W406.PubMedCrossRef
57.
Becker, S., & Ichino, A. (2002). Estimation of average treatment effects based on propensity scores. The Stata Journal, 2(4), 358–377.
58.
StataCorp. (2007). Stata statistical software: Release 10. College Station, TX: StataCorp LP.
59.
Austin, P. C. (2009). Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Statistics in Medicine, 28(25), 3083–3107.PubMedCrossRef
Metadata
Title
Measuring the Impact of Hurricane Katrina on Access to a Personal Healthcare Provider: The Use of the National Survey of Children’s Health for an External Comparison Group
Authors
Tasha Stehling-Ariza
Yoon Soo Park
Jonathan J. Sury
David Abramson
Publication date
01-04-2012
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue Special Issue 1/2012
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-012-1006-y

Other articles of this Special Issue 1/2012

Maternal and Child Health Journal 1/2012 Go to the issue

EditorialNotes

Introduction to the Special Issue of Articles from the 2007 National Survey of Children’s Health

OriginalPaper

Oral Health Need and Access to Dental Services: Evidence from the National Survey of Children’s Health, 2007

OriginalPaper

Does a Medical Home Influence the Effect of Low Birthweight on Health Outcomes?

OriginalPaper

Medical Home Access Among American Indian and Alaska Native Children in 7 States: National Survey of Children’s Health

OriginalPaper

Value for the Money Spent? Exploring the Relationship Between Expenditures, Insurance Adequacy, and Access to Care for Publicly Insured Children

OriginalPaper

Characteristics of Children Eligible for Public Health Insurance but Uninsured: Data from the 2007 National Survey of Children’s Health