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10. Young Children and Well-Child Visits

While it is common to speak about health maintenance among the adult population, children – and young children in particular – grow rapidly and set a health trajectory that affects future growth and development. Early identification and response to conditions that can affect that development is key to healthy development and the reason for regular well-child check-ups. Bright Futures, a comprehensive document regarding the components of well-child visits, contains a periodicity chart for well-child visits, with at least annual visits during the first five years of life. Well-child visits support early detection of potential areas of concern. They can also support parents in providing a healthy environment for their children by allowing them to seek information and advice about growth, behavior and physical and emotional development. 

What Can the Data Tell Us?

In most states and nationally, there are troubling racial and economic disparities in the ability of families to access preventive care, including well-child visits, for their children. The following data from the National Survey on Children’s Health (Table 19) show that in some states, the percentage of children of color who do not have preventive care is twice that for white children.  For most states and nationally, children living below the poverty level are twice as likely not to have seen a doctor, nurse, or other health care provider for preventive medical care in the last 12 months in comparison to children living at 400 percent or more of the poverty level.  The share of children not having a physical examination or well-child check-up is higher for the 0-17 population than the 0-5 population because annual examinations are not necessarily expected for older children. The 0-17 data are shown for comparative purposes by race/ethnicity and poverty level. It is important for states to put in place resources and policies that help families of color and families living in poverty to better access preventive care, including well-child visits for children birth to five years.

Table 19. Percentage of children who have not seen a doctor, nurse or other health care provider for preventive medical care, such as a physical exam or well-child checkup, in the past 12 months, U.S. and states, 2011-2012*