Children with special health care needs more likely to have health care access problems

U.S. Department of Health & Human Services
Health Resources and Services Administration
Monday, December 05, 2011

New HRSA report also finds greater health risks at home

In the first national report that compares the health and well-being of children with special health care needs to those children without, findings revealed that 14 to 19 percent of children in the United States have a special health care need, representing more than one in five households with children. Children with Special Health Care Needs in Context:  A Portrait of the Nation in 2007, prepared by the Health Resources and Services Administration (HRSA), examines these children in the context of where they live, play and go to school.  Data for the report comes from The National Survey of Children’s Health, a national survey about the health and well being of more than 90,000 children in the U.S.

The report identifies children with special health care needs (CSHCN)  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 related services. The report also provides information on a state-by-state basis.

“The findings in this report help ensure that children with special health care needs continue to be at the forefront of policy making as we work to expand access, improve quality and promote wellness for all Americans, including this vulnerable and important population,” said HRSA Administrator Mary K. Wakefield, Ph.D., R.N.

The report found that many CSHCN are:

  • more likely than other children to have consistent insurance; however, that insurance is less likely to meet their needs, and they are less likely than non-CSHCN to receive care that meets the criteria for having a medical home;   
  • less likely to be engaged in school, and more likely to repeat a grade and miss more than two weeks of school due to illness;
  • more likely to be overweight or obese than children without special health care needs; and
  • more likely than children without special health care needs to be exposed to secondhand smoke at home.

All of the estimates presented in the report are based on parents’ reports, with only those differences that are statistically significant included.  Technical appendices at the end of the report present information about the survey methodology and sample.  

The report, sponsored by HRSA’s Maternal and Child Health Bureau, is available in print and online. Review more information about the report and its findings and order print copies through the HRSA Information Center toll-free at 1-888-ASK-HRSA or online at  


The Health Resources and Services Administration is part of the U. S. Department of Health and Human Services. HRSA is the primary federal agency responsible for improving access to health care services for people who are uninsured, isolated, or medically vulnerable. For more information about HRSA and its programs, visit

Date Last Reviewed:  March 2017