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Employment change and the role of the medical home for married and single-mother families with children with special health care needs

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  • DeRigne, LeaAnne
  • Porterfield, Shirley

Abstract

One in five U.S. households with children has at least one child with a special health care need (USDHHS, 2004). Like most parents, those with children with special health care needs struggle to balance child-rearing responsibilities with employment demands. This research examines factors affecting married parents' and single-mother's employment change decisions focusing specifically on whether having a medical home influences these decisions. This study includes 38,569 children with special health care needs from birth through age 17 surveyed in the 2005-2006 National Survey of Children with Special Health Care Needs. The employment model is estimated using multinomial logistic regression with the choice of a parent to maintain their current level of employment, reduce work hours, or stop working as the dependent variable. Independent variables are those characterizing the needs of the child, the resources of the family, and the socio-demographic characteristics of the family. Components of the medical home variable include: 1) having a usual source of care; 2) care provided is "family centered"; 3)Â receipt of care coordination services; and 4) receipt of needed referrals. Half of the children in our sample met criteria in all four facets. If the child has a medical home, the relative risk of a parent choosing to cut hours rather than not change hours decreases by 51%. The relative risk of choosing to stop working rather than not change hours decreases by an estimated 64%. Care coordination services significantly reduce the odds of changing employment status. Our results suggest that the medical home is a moderating factor in parental decisions concerning change in employment status.

Suggested Citation

  • DeRigne, LeaAnne & Porterfield, Shirley, 2010. "Employment change and the role of the medical home for married and single-mother families with children with special health care needs," Social Science & Medicine, Elsevier, vol. 70(4), pages 631-641, February.
    • Handle: RePEc:eee:socmed:v:70:y:2010:i:4:p:631-641
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    2. Julie Vinck & Idunn Brekke, 2019. "Gender and education inequalities in parental employment when having a young child with increased care needs: Belgium and Norway compared," Working Papers 1904, Herman Deleeck Centre for Social Policy, University of Antwerp.
    3. Sullivan, Amanda L. & Farnsworth, Elyse M. & Susman-Stillman, Amy, 2018. "Patterns and predictors of childcare subsidies for children with and without special needs," Children and Youth Services Review, Elsevier, vol. 88(C), pages 218-228.
    4. Costanzo, Molly A. & Magnuson, Katherine, 2019. "How does disability influence child care arrangements for young children? An examination using the NHES ECPP," Children and Youth Services Review, Elsevier, vol. 99(C), pages 210-225.
    5. Stoddard-Dare, Patricia & DeRigne, LeaAnne & Quinn, Linda M. & Mallett, Christopher, 2015. "Material hardship in families with children with health conditions: Implications for practice," Children and Youth Services Review, Elsevier, vol. 49(C), pages 11-19.
    6. Katharine Venter, 2011. "Fathers ‘Care’ Too: The Impact of Family Relationships on the Experience of Work for Parents of Disabled Children," Sociological Research Online, , vol. 16(3), pages 66-81, August.

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