Economy-Sensitive Conditions: Are Some Pediatric Hospitalizations Triggered By Economic Recessions?

• Published in: Health affairs (Millwood, Va.) Vol. 39; no. 10; pp. 1783 - 1791I
• Main Authors: Colvin, Jeffrey D, Richardson, Troy, Ginther, Donna K, Hall, Matt, Chung, Paul J
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.10.2020
• Subjects: Asthma; Child; Child abuse & neglect; Children; Children & youth; Childrens health; Codes; Complex patients; Complexity; Counties; Diabetes; Diabetes mellitus; Drug abuse; Economic conditions; Economic Recession; Economics; Ethnicity; Family income; Great Recession; Health care expenditures; Hospitalization; Hospitals; Households; Humans; Impact analysis; Medicine; Mental disorders; Mental Health; Mortality; Pediatrics; Poisoning; Recessions; Substance abuse; Substance-Related Disorders; Unemployment; New York; Rhode Island; United States > US; Kentucky; Florida; New Jersey; Michigan
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2020.00732

The impact of economic recessions on child health is complex and varied. Here we examine associations between county-level unemployment and pediatric hospitalizations in fourteen states every third year from 2002 to 2014. After adjusting for state-specific effects of unemployment across all counties and years, we found that increased unemployment was associated with increased pediatric hospitalizations for four potentially economy-sensitive conditions, such that a 1 percent increase in unemployment was associated with a 5 percent increase in hospitalizations for substance abuse, a 4 percent increase for diabetes mellitus, and a 2 percent increase both for children with medical complexity and for poisoning and burns. Mean pediatric all-cause hospitalizations increased by 2 percent for every 1 percent increase in unemployment (or 54,177 excess hospitalizations in 2011 compared with 2005). Hospitalizations for mental health, despite the increased severity of these conditions during recessions, were not associated with unemployment. Further research is needed to examine potential federal, state, and local policies that may mitigate the influence of unemployment on child health and pediatric hospitalizations.