Effects of Family Resources On Parental Health and Employment Status Among Families of Children with Special Health Care Needs

Purpose: Chronic illness or disability in a child is an enduring and important life stressor that can impact the lives of children and their families, thus, placing them further at risk for disturbance of emotional and social function. Past research has revealed that children with special health care needs (CSHCN) place great demands on parents in terms of their finances, employment and mental and physical health. A large body of research based on several national health surveys has identified the prevalence and characteristics of CSHCN and their related medical needs. These studies primarily use the epidemiological approach to identify risk factors and health patterns among CSHCN. Information about how families adjust to a variety of demands associated with caring CSHCN is seldom addressed. To fill this gap in the literature, the aim of this study is to examine how family resources, including family structure, insurance, and family support, help families cope with the stress of raising a CSHCN in terms of parental employment and health status.

Method: The analysis utilizes secondary data from the 2010 National Health Interview Survey (NHIS). CSHCN in the dataset were identified using an adaptation of Davidoff’s (2004) design of the Children with Special Health Care Needs Screener which was constructed based on the Maternal and Child Health Bureau’s conceptual definition of CSHCN and the survey questions of NHIS. Bivariate analyses, including t-tests and chi-square, were employed to examine the associations between family resources and parental employment and health status. Multinominal logistic regression (MLR) was conducted to examine predictors of parental employment and health status.  

Results: Out of the 11,277 individuals younger than 18 years of age in the NHIS, 2,932 (26%) were identified as CSHCN.  Among these family resource predictors, only insurance status was significantly associated with parental general and mental health. After adjustment for child age, public insurance and family income (near poor) were significantly associated with parental unemployment status. Additionally, family income (poor) was significantly associated with parental health.

Conclusions and Implications: It is estimated that in 2010 approximately 19 million U.S. children younger than 18 years have special health care needs. This suggests an increase in the number of CSHCN over the last 10 years (Newacheck & Kim, 2005). Findings also indicate parents of CSHCN with lower income are more likely to experience mental stress and unemployment. Policy-makers and practitioners need to pay particular attention to the needs of families who are economically disadvantaged. The relationship  between CSHCN’s public insurance and parental unemployment warrants further investigation to clarify whether obtaining the eligibility of public insurance to meet children’s medical needs results in parental unemployment or vice versa.