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Introduction

This chartbook uses the 2007 National Survey of Children’s Health (NSCH) to report on recent findings on children with special health care needs (CSHCN) in the United States. The NSCH provides a unique view of CSHCN in the context of where they live, play and go to school. It also allows comparisons to children without special health care needs.

Children with special health care needs (CSHCN) are defined in the National Survey of Children’s Health as those who have one or more chronic physical, developmental, behavioral or emotional conditions for which they require an above routine type or amount of health and related services. Based on this definition of CSHCN, as set forth by the Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (MCHB),1 recent data show that 14-19 percent of children in the United States have a special health care need, representing over 1 in 5 households with children.*

The 2007 NSCH is a national, parent-reported telephone survey sponsored with funding and direction from the Health Resources and Services Administration’s Maternal and Child Health Bureau and conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. The survey, also conducted in 2003 and again in 2011, provides a consistent source of data on the health, community and family-related experiences of children with and without special health care needs in the nation and in each state. The 2007 version of the NSCH represents the most recent national and state-representative data about CSHCN and children without special health care needs (non-CSHCN). All of the estimates presented here are based on parents’ reports, and only those differences that are statistically significant are included. A technical description of the survey methodology is available at the Data Resource Center for Child and Adolescent Health External Web Site Policy.

Children with special health care needs come from all racial and ethnic groups, ages, and family income levels. CSHCN encompass a wide variety of health conditions, with most children having more than one condition. All CSHCN require special health care services for one or more ongoing health conditions. However, these children naturally vary in their functional abilities. Nearly all CSHCN experience some type of functional difficulty. Yet, many are nonetheless able to participate in daily activities like other children their age, while others are significantly affected by their conditions.

This chartbook both reports on topics not addressed in other national surveys on CSHCN and provides a comparison of CSHCN in the United States to those children who do not have ongoing special health needs, with specific attention to the following focus areas:

In addition, the chartbook contains a State Data section which shows many indicators for each of the 50 states and the District of Columbia. An interactive version of each state page is also available at the Data Resource Center for Child and Adolescent Health External Web Site Policy. From the interactive pages, you can compare States and look at additional subgroups of children by characteristics such as income and type of insurance coverage.

The indicators presented in the chartbook represent an enriched approach to the analysis of the health and health care of CSHCN by:

Additional information about the chartbook’s sources and analysis can be found in the Technical Appendix.

1 McPherson M, Arango P, Fox H, et al. A new definition of children with special health care needs. Pediatrics. 1998;102(1 Pt 1):137-140.

*Prevalence of CSHCN is measured both in the National Survey of Children’s Health and the National Survey of Children With Special Health Care Needs. Variations in sampling and administration lead to expected variations in prevalence. The 2005/06 NS-CSHCN estimates 13.9 percent prevalence and the 2007 NSCH estimates 19.2 percent prevalence. For more information, contact the Data Resource Center External Web Site Policy or the National Survey of Children's Health External Web Site Policy on the Data Resource Center site.

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