Income and Household Material Hardship in Children With Medical Complexity.

Creator(s)

Margaret Wright, Children's Mercy HospitalFollow
Isabella Zaniletti
Emily J. Goodwin, Children's Mercy Kansas CityFollow
Rupal C. Gupta
Ingrid A. Larson
Courtney Winterer
Matt Hall
Jeffrey D. Colvin, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

4-1-2024

Identifier

DOI: 10.1542/hpeds.2023-007563

Abstract

BACKGROUND AND OBJECTIVES: Household economic hardship negatively impacts child health but may not be adequately captured by income. We sought to determine the prevalence of household material hardship (HMH), a measure of household economic hardship, and to examine the relationship between household poverty and material hardship in a population of children with medical complexity.

METHODS: We conducted a cross-sectional survey study of parents of children with medical complexity receiving primary care at a tertiary children's hospital. Our main predictor was household income as a percentage of the federal poverty limit (FPL):100% FPL. Our outcome was HMH measured as food, housing, and energy insecurity. We performed logistic regression models to calculate adjusted odds ratios of having ≥1 HMH, adjusted for patient and clinical characteristics from surveys and the Pediatric Health Information System.

RESULTS: At least 1 material hardship was present in 40.9% of participants and 28.2% of the highest FPL group. Families with incomes < 50% FPL and 51% to 100% FPL had ∼75% higher odds of having ≥1 material hardship compared with those with >100% FPL ( < 50% FPL: odds ratio 1.74 [95% confidence interval: 1.11-2.73], P = .02; 51% to 100% FPL: 1.73 [95% confidence interval: 1.09-2.73], P = .02).

CONCLUSIONS: Poverty underestimated household economic hardship. Although households with incomes < 100% FPL had higher odds of having ≥1 material hardship, one-quarter of families in the highest FPL group also had ≥1 material hardship.

Journal Title

Hosp Pediatr

Volume

14

Issue

4

First Page

195

Last Page

200

MeSH Keywords

Child; Humans; Cross-Sectional Studies; Income; Poverty; Parents; Surveys and Questionnaires

Keywords

Cross-Sectional Studies; Income; Poverty; Parents; Surveys and Questionnaires

Recommended Citation

Wright SM, Zaniletti I, Goodwin EJ, et al. Income and Household Material Hardship in Children With Medical Complexity. Hosp Pediatr. 2024;14(4):e195-e200. doi:10.1542/hpeds.2023-007563