Date of Award

Summer 8-13-2019

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Ike Okosun

Second Advisor

Reynolds Morrison

Abstract

INTRODUCTION: Mental health disorders affect an individual’s emotional, psychological, and social well-being and affects 13-20% of adolescents between the age of 13 to 18. Majority of term mental illnesses start in childhood and adolescent years, with 50% of all lifetime cases starting around age 14 years. Treatment at early ages means decreased risk of long-term problems linked to mental disorders like alcohol and drug abuse. Children living in poverty have a higher risk factor for mental disorders and may also have limited access to quality mental health care.

AIM: This study aims to examine the relationship between access to mental healthcare and whether a child lives in an impoverished household using data from the 2017 National Survey of Children’s Heath (NSCH).

METHODS: The NSCH is a cross-sectional survey that collects information on the physical and emotional health; parent and neighborhood characteristics of a nationally representative sample of children aged 0-17 years. A total of 58,510 participants were interviewed in the 2017 wave of the survey. Descriptive statistics and logistic regression analysis were used to examine the associations between poverty, mental health treatment, and access to health insurance.

RESULTS: There were a total of 2723 total children averaging 11 years were included in this analysis, 14.4% of which did not have access to mental health. Approximately 52% of children were male, and majority were white (77.3%). Roughly 15% of the children lived in poor households with income below the 100% federal poverty level (FPL). Seeking a mental health professional for treatment was significantly associated with race, education of caretaker, insurance status, and federal poverty level. After adjusting for all factors, children who lived in households below 100% FPL were significantly more likely to report not having access to mental healthcare that was needed (OR=2.235, 95% CI:1.564, 3.192).

DISCUSSION: The results suggest that there is a strong association between child poverty and lack of access to needed mental health. There is a need for interventions to improve access to mental health care services for children from poor households in order to prevent further complications, and other long-term health problems including caretaker education and decreased stigma surrounding the topic of childhood mental illness. Further research can also help identify other factors that impact childhood mental disorders and disparities in access to treatment among underrepresented populations as well as create a more generalizable study through the use of other survey methods and a more diverse group of children.

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