The Health of Children in U.S. Military Families: Evaluation of the 2020-21 National Survey of Children’s Health

Abstract

ABSTRACT Introduction The health of children and adolescents, particularly children of military families, is instrumental for military departments; yet, there has not been an examination on the overall physical health status, or access to health care, among children of military families compared to children of civilian families. Materials and Methods This study used the 2020-2021 National Survey of Children’s Health, children aged 0–17 years, to examine the association between military status of the caregiver of the child and the child’s health status, financial stability, and health care access via health insurance coverage (n = 90,711 children). Bivariate analyses used Pearson’s chi-squared tests and were weighted to be nationally representative. Multivariable regression analyses were used to examine the association between military status and selected health outcomes. Results In unadjusted analyses, we found that children who had ever had a caregiver serve on active duty were overall more financially stable than children with a civilian caregiver, with children of military families less likely to reside below the federal poverty level and more likely to have continuous health insurance coverage. We also found that children with a caregiver who has ever been on active duty were more likely to have reported mental health needs and more likely to have special health care needs than their civilian counterparts. In adjusted analyses, children with a caregiver who has ever been on active duty were more likely to have special health care needs (adjusted odds ratio [aOR] 1.22; 95% confidence interval [CI] 1.10–1.36) and mental health needs (aOR 1.22; 95% CI 1.10–1.35). Conclusions This is the first study, to our knowledge, to do a national examination of overall physical and mental health, as well as specific health conditions and access to health care, among children of military families compared to their civilian counterparts. The findings from this study may be instructive for policymakers and stakeholders in evaluating special needs and mental health resources for military families and improve continuity of health care access through insurance coverage to improve the health of all U.S. children and adolescents.