Children in Ohios Appalachian Counties Face Similar Health Care Challenges to Metropolitan Areas, Study Finds

August 28, 2015

Despite the fact that previous research shows the Appalachian region of the United States as limited in access to health care services, researchers at Nationwide Children’s Hospital have found that children with special health care needs in Appalachian areas face similar levels of health status as their metropolitan counterparts.

Researchers used data from the 2012 Ohio Medicaid Assessment Survey, which is designed to examine the health status and health insurance needs of Ohio adults and children. This study, published today in the Journal of Health Care for the Poor and Underserved, is one of the first of its kind to use a population-based survey to assess the health status of children with special health care needs (identified by The Federal Maternal and Child Health Bureau as CSHCN) in Appalachian Ohio. Results showed that children with special needs living in Appalachian Ohio counties are poorer and more likely to be insured by Medicaid than their metropolitan counterparts, but otherwise face the same health care challenges as those in urban areas.

“One marked difference is that children with special needs in Appalachia are more likely to frequent emergency departments, and less likely to have access to primary care,” said Deena Chisolm, PhD, principal investigator in the Center for Innovation in Pediatric Practice at The Research Institute at Nationwide Children’s Hospital and co-author of the study. “This trend raises concerns about access to appropriate levels of service that should be explored in future research.”

The OMAS surveyed approximately 23,000 Ohio residents between May 2012 and August 2012 with an overall response rate of 29.4 percent. Households with children were purposefully oversampled. A child met the definition of CSHCN if the survey respondent reported that the child used prescription medication, used more health or educational services than other children, was limited in their ability to do things most similarly-aged children could do, received special therapy or received emotional or behavioral counseling and that the condition or services use was expected to last for greater than 12 months.

“Primary care is important for all children, and crucial for children with special needs,” said Dr. Chisolm. “Further research is necessary in order to better understand how to best serve children with special health care needs who live in very rural areas and Appalachia.”

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2019-20 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.5 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at