Parents of young children have trouble accessing medical care for themselves or their children. Not being able to secure child care and rules restricting children at appointments have resulted in canceled appointments, delayed care, and even medical interventions that are delayed indefinitely.
Capita recently hosted a convening to discuss the barriers that child care poses to medical care. This convening was primarily a “level-setting” conversation: rather than presenting answers, we asked for input from stakeholders to understand the issue and possible solutions.
We’ve also conducted our own polling to investigate the scope of this problem. The results were sobering: 41% of parents in our survey delayed accessing healthcare for themselves within the past year! Nearly one-quarter of parents overall (22%) said difficulty finding someone to care for their child(ren) caused them to delay or not access the healthcare they needed for themselves. Most child care-related delays involve routine care, dental care, and minor injuries. However, nearly one-third (29%) of parents who delayed care due to childcare barriers did so for a chronic condition, more than one-quarter (27%) delayed mental healthcare, 14% delayed emergency or urgent care they knew they needed, and 8% delayed pregnancy-related care.
We presented the results of this research at the convening and also heard from two outside experts: a physician with empirical research expertise in the area and a social worker and advocate familiar with the problem. First, we heard from and spoke to Anisha P. Ganguly, MD, an Assistant Professor of Medicine at the University of North Carolina at Chapel Hill. In addition to her busy clinical practice, Dr. Ganguly is a leading researcher in this field. Here are a few key takeaways:
Empirical Evidence Demonstrates a Real Problem
First, there is absolutely a real problem here. Dr. Ganguly told us that lack of childcare is a significant barrier for parents’ ability to access healthcare. For example, she talked to us about a review of the empirical literature that showed childcare needs to be a key barrier to accessing healthcare. Indeed, they are just as important as other issues that often receive more attention, such as the lack of transportation. As an example, she showed us a research study that focused on the reasons low-income women had trouble accessing medical care, which found that 17% of such participants in this category were prevented from accessing care because of childcare issues.
Yet, creative solutions exist. For example, we heard about an innovative program at a hospital in Texas that allowed drop-off childcare for both patients and staff. That program has since closed, but it was an intriguing example of potential solutions.
Individual Stories Highlight Gaps in Our Safety Nets
Second, we heard from Kate Warren Barnes at the Prenatal-to-5 (P5) Policy Network. Warren Barnes shared her personal experience in this area, drawing on her expertise and advocacy in this issue. For example, Warren Barnes told us that in Massachusetts, the local Medicaid program does provide free transportation for a child and their caregiver to access medical care. However, the program only pays for a single child and parent—meaning a parent with multiple children at home frequently runs into issues. Sometimes, Warren Barnes told us, the driver will “look the other way,” and allow a parent to bring more than one child. However, if they don’t, the parent will be faced with a choice between skipping a needed appointment, or leaving her or his other children at home unsupervised, possibly resulting in involvement by the local child and family services department. We’ve heard similar stories from talking to providers in other states— Connecticut, for example, also allows only one parent and one child on transportation funded by Medicaid, creating obstacles for parents with more than one young child.
Going forward, we look forward to continuing our research on this critical issue. We plan to host parent roundtables in the near future, culminating in public-facing work that will advance a needed conversation on policy responses. If you have an interest in this issue, or would like to speak to us about it, please feel free to reach out to the members of Capita’s Family Policy Lab:
