The pandemic has led to so many devastating side effects, and one in particular is worrying us: there has been a sharp decline across the country in the number of kids receiving primary and preventative care appointments, known as well-child visits. With COVID-19 rates rising and many states issuing stay-at-home orders once again, it is becoming even more concerning.
The numbers are alarming: for children 18 and younger who are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP), there was a 40 percent decrease in health screenings and a 44 percent decrease in outpatient mental health services from March to May of this year. Even after stay-at-home measures loosened in some states, the use of primary and preventative care stayed far behind pre-pandemic levels.*
Why does this matter? Without primary care check-ups, kids miss out on essential physical healthcare that could dramatically impact their health, even save their lives. Medical providers can be a support for caregivers, especially those living in marginalized communities cut off from vital resources like food and housing assistance. As medical practices work to prioritize child emotional wellbeing in overall health, having access to pediatricians can also help children who need mental health interventions.
We spoke to Senior Medical Advisor at Children’s Health Fund Dr. Susan Spalding about the importance of preventative medical care for kids and why more needs to be done to ensure they are receiving care, even during the pandemic.
What is a well-child visit?
Well-child visits are a critical part of children’s care: the American Academy of Pediatrics recommends 30 regularly-scheduled visits from birth to age 21! These visits are a time when medical providers assess a child’s growth and development, perform a physical exam, and give important immunizations to protect against serious illnesses. They are also a time when caregivers can ask about any health topics they are wondering about.
What is the importance of these checkups and ongoing primary care at different stages of a child’s development?
Each visit matches the developmental stage of a child, and providers focus on things that kids experience at different ages. At newborn visits, the discussion is often about breastfeeding and sleeping, and as a baby grows the topics may be about foods and new developmental milestones like babbling and sitting. Preschool, school readiness, and using electronic devices will come up as a child grows. Pediatricians talk to teenagers about smoking, drugs, social media, and sex. Safety is an important topic that is covered at every visit, from car seats to alcohol and driving.
What can happen when a child isn’t able to get these regular checkups?
Caregivers and kids could miss out on essential information for their health and safety. For instance, caregivers might not know that reading starting at six months is important for brain development. Or that eyes that are crossed are normal at one age but not another. And talking about sensitive topics with teenagers can be hard, but necessary. These are all topics that come up during well-child visits and can have long-term impacts on health. Without these visits, parents may not catch speech and cognitive delays, for example, thus delaying needed support. Missing these windows could dramatically affect learning and progress in school.
How is the pandemic affecting access to these services?
While adult primary care visits have returned almost to pre-pandemic levels, pediatric visits and immunization rates have been slower to rebound. This can be a problem because kids tend to look healthy even if they aren’t developing or growing well. For instance, a caregiver might not be concerned if a child is quiet or withdrawn, when in reality it may be an indicator of something more serious. For kids in some households that are experiencing the chaos of job loss, housing instability, and remote learning in crowded quarters, symptoms of mental and physical issues could be overlooked.
How is Children’s Health Fund supporting programs to overcome these challenges?
At the onset of stay at home orders, the programs we support across the country rapidly implemented telehealth services to stay connected to their patients. As the country began to open up, the clinics opened as well, but with necessary safety measures like social distancing, extra cleaning, mask-wearing, and other personal protective equipment. All or some parts of a well-child visit can be done through telehealth, depending on the circumstances, but immunizations and testing must still be done in person. And immunizations are the most important way to keep a child safe from 16 infections. During the pandemic, childhood vaccination rates have dropped significantly, and many of us are worried about the spread of preventable diseases among kids.
Why should we make well-child visits and ongoing primary healthcare for children a priority?
Well-child visits and vaccinations are one of the most important ways to ensure children grow up healthy. At a time when many have lost access to support systems and resources, especially families facing financial hardship and families of color, they are even more crucial.