Associations of Preventive Medicine and Dental Visits with Child Care

Objectives: To assess associations between child care versus solely parent care with ≥ 1 visit for preventive medical and dental care during the past 12 months for US children 1-5 years old (yo).

Methods:  Bi-variate and multi-variate analysis on child care and health care utilization were evaluated using the 2007 National Survey of Children’s Health, a telephone interview of parent reported children’s health (n=22,773).  Child care categories were: solely parent (42.9%), center (24.2%), non-relative home (7.9%), relative (14.0%), or mixed (11.1%, mixture of relative and non-relative including center).  Co-variates included: sex; race/ethnicity, English spoken at home, single mother, household number of children, poverty, mother’s education and non-US birth, type of health insurance, and reported child’s overall health status and teeth condition.

Results:   Overall, 94.7% of children 1-5yo received ≥ 1 preventive medical care visit while only 53.6% received ≥ 1 preventive dental visit.  The highest rate of medical visits occurred in year one (98.6%) which was the age of lowest dental visits (13.8%).   The highest odds for preventive medical visit for children 1-2yo was for children utilizing center care contrasted to parent care with OR=4.6 (95% CI 2.0-10.6) unadjusted and OR=2.9 (1.1-7.8) adjusted; for children 3-5yo, the highest odds were for children who received mixed child care, OR=2.5 (1.6-3.9) unadjusted and 1.9 (1.1-3.1) adjusted, followed by center care with 2.3 (1.6-3.2) unadjusted and 1.5 (1.0-2.2) adjusted.  Dental visits were only statistically higher than parent care for children 1-2yo receiving center care: OR=1.7(1.2-2.6) unadjusted and 1.9(1.2-3.0) adjusted. 

Conclusions: Prevalences of medical and dental preventive visits were strikingly different for children 1-5yo.   Increased odds among children attending child care centers of preventive medical visits for children 1-5 and of preventive dental visits among children 1-2 suggest child care regulations may provide potential interventions for increased preventive health care services for young children.