Jessica Beetch, Amanda Janitz, Laura A Beebe, Chao Xu, Mary Gowin, Katrin Gaardbo Kuhn
{"title":"Indirect Effects of the COVID-19 Pandemic on Well-Child Visits in Low-Income Children in Oklahoma.","authors":"Jessica Beetch, Amanda Janitz, Laura A Beebe, Chao Xu, Mary Gowin, Katrin Gaardbo Kuhn","doi":"10.1097/PHH.0000000000002144","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>During the COVID-19 pandemic, well-child visits were widely delayed or missed. Delays in routine care are more likely for low-income individuals and families who already face barriers to attending visits. Studies in the literature indicate declines in well-child visits during the pandemic but few have focused on low-income children and none have examined children in Oklahoma.</p><p><strong>Objective: </strong>To evaluate changes in well-child visit attendance during the COVID-19 pandemic in low-income children residing in Oklahoma.</p><p><strong>Design and setting: </strong>This retrospective cohort study used data from the Oklahoma Health Care Authority before COVID-19 emergence (March 1, 2017-July 31, 2019) and during the COVID-19 pandemic (March 1, 2020-July 31, 2022).</p><p><strong>Participants: </strong>We studied children under 1 year of age attending well-child visits.</p><p><strong>Main outcome measures: </strong>We calculated percentage change in the total number of well-child visits before and during the pandemic, including different phases and months during the pandemic. Log-binomial regression was performed with unique children who attended 6 or more well-child visits or less than 6 well-child visits before COVID-19 emergence or during the pandemic.</p><p><strong>Results: </strong>We analyzed 194 126 children under 1 year of age attending 778 483 well-child visits. There was a 10.43% decrease in the total number of well-child visits during the COVID-19 pandemic compared to before it began, with a 5.18% decrease during the initial impact phase, 5.99% decrease during the initial recovery phase, 1.14% decrease during Delta variant predominance, and 13.79% decrease during Omicron variant predominance. Besides American Indian children, all other races were less likely to attend 6 or more well-child visits during the pandemic compared to before it began.</p><p><strong>Conclusion: </strong>We observed declines in well-child visits during the COVID-19 pandemic with evident racial disparities. Catch-up efforts are essential to return to pre-pandemic levels of well-child visit attendance.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Public Health Management and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PHH.0000000000002144","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Indirect Effects of the COVID-19 Pandemic on Well-Child Visits in Low-Income Children in Oklahoma.
Context: During the COVID-19 pandemic, well-child visits were widely delayed or missed. Delays in routine care are more likely for low-income individuals and families who already face barriers to attending visits. Studies in the literature indicate declines in well-child visits during the pandemic but few have focused on low-income children and none have examined children in Oklahoma.
Objective: To evaluate changes in well-child visit attendance during the COVID-19 pandemic in low-income children residing in Oklahoma.
Design and setting: This retrospective cohort study used data from the Oklahoma Health Care Authority before COVID-19 emergence (March 1, 2017-July 31, 2019) and during the COVID-19 pandemic (March 1, 2020-July 31, 2022).
Participants: We studied children under 1 year of age attending well-child visits.
Main outcome measures: We calculated percentage change in the total number of well-child visits before and during the pandemic, including different phases and months during the pandemic. Log-binomial regression was performed with unique children who attended 6 or more well-child visits or less than 6 well-child visits before COVID-19 emergence or during the pandemic.
Results: We analyzed 194 126 children under 1 year of age attending 778 483 well-child visits. There was a 10.43% decrease in the total number of well-child visits during the COVID-19 pandemic compared to before it began, with a 5.18% decrease during the initial impact phase, 5.99% decrease during the initial recovery phase, 1.14% decrease during Delta variant predominance, and 13.79% decrease during Omicron variant predominance. Besides American Indian children, all other races were less likely to attend 6 or more well-child visits during the pandemic compared to before it began.
Conclusion: We observed declines in well-child visits during the COVID-19 pandemic with evident racial disparities. Catch-up efforts are essential to return to pre-pandemic levels of well-child visit attendance.
期刊介绍：
Journal of Public Health Management and Practice publishes articles which focus on evidence based public health practice and research. The journal is a bi-monthly peer-reviewed publication guided by a multidisciplinary editorial board of administrators, practitioners and scientists. Journal of Public Health Management and Practice publishes in a wide range of population health topics including research to practice; emergency preparedness; bioterrorism; infectious disease surveillance; environmental health; community health assessment, chronic disease prevention and health promotion, and academic-practice linkages.
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