TABLE 7.1 Children's Needs for Health Care, United States, 1992


Percentage of Population

Number (millions)

Percentage of Total Expenses





Mild or Moderate Chronic Conditions



10-20 (2-3 times)

Severe Chronic Conditions



70-80 (5-6 times)


SOURCE: Neff and Andersen, 1992. Data are from the National Health Interview Survey as cited by Newacheck and Taylor, 1992.

needs, and then discusses some of the committee's concerns associated with managed care and its effects on access to health care for these children.

Certainly when we talk about children's health care status, we need to recognize how different children are, and how different their health care needs are from adults. Children face many obstacles in health care, but one of the hardest to overcome is the way most people view child health issues. When considering therapeutic interventions, medicines must be more finely calibrated, and diagnostic procedures may be more difficult. Young children, who have only a limited ability to communicate, must be examined more closely to diagnose and monitor illnesses.

Steve Edwards

American Academy of Pediatrics, Raleigh, NC

Public Workshop, June 2, 1997

Epidemiology Of Illnesses In Children

Acute Illnesses

For most healthy children, a pediatrician, family physician, or other primary care practitioner (e.g., nurse practitioner or physician assistant) is usually the main source of preventive and acute medical care. Depending on the setting for care and the availability of allied health professionals on staff, these primary care practitioners also provide health education for parents and children, refer them for specialty consultations, and coordinate their care, as appropriate. Expanded services such as behavioral counseling, nutrition education, and parenting skills training also may be provided in a primary care setting.

Table 7.2 compares the frequency of acute illnesses and injuries for children with the general population. Infections are the most common acute illnesses of children, especially respiratory infections. Young children (ages 1 to 5 years) have significantly higher rates of acute illnesses than older children (ages 5 to 17 years) or than the general population.

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