Study Hypothesis

Children’s HealthWatch interview data are used to continually monitor the following hypothesis:

Changes in public policies, including public assistance programs, and public spending and the fluctuations of the economy impact the nutrition, health and development of young children and the health and economic well-being of their families.

Children’s HealthWatch monitors, among other key indicators:

Child health:

  • Health status
  • Developmental risk (measured by the Parents’ Evaluation of Developmental Status or PEDS)
  • Weight-for-age and weight-for-height measurements (anthropometrics)
  • Health care utilization history: admission from the emergency department and lifetime hospitalizations

Caregiver health:

  • Health status
  • Mental health

Household economic hardships

  • food insecurity and hunger 
  • housing instability (e.g. history of homelessness, behind on rent/mortgage, multiple moves)
  • household energy security (e.g. inability to pay utility bill, unheated/uncooled days)
  • health care hardships (e.g. forgone care due to cost or care received but difficulty paying for other needs as a result)
  • child care constraints (difficulty obtaining child care causing caregiver inability to work or study as desired)

Children’s HealthWatch is uniquely positioned to demonstrate the effects on children’s and families’ health of changes to public policy and the economy, given our long history of data collection during economic booms and recessions. Monitoring data since 1998, the Children’s HealthWatch dataset currently includes over 75,000 interviews with caregiver and young child dyads.

Electronic Health Record Repository

In three of our five sites we  have additionally developed an electronic health record (EHR) repository, which allows us to follow children’s health and health care utilization longitudinally over time.  The repository contains linked records (survey and EHR data) from children from our Boston, Minneapolis, and Little Rock sites.  We hope to add Philadelphia and Baltimore in the future.  The records have also been geocoded, which allows examination of geospatial and exposure data, such as pollution and noise exposure or green-space and food access, as well as Census data at the parcel level, like income.

COVID-19 Follow-Up Study

Starting in August 2020 we launched our COVID-19 Follow-Up Study.  Learn more here.

Study Location

Why monitor children in acute/primary care clinics and emergency departments?

The Children’s HealthWatch sample comprises a vulnerable sentinel group who will show effects of a given situation before the wider population (like “canaries in a coal mine”). Emergency departments and acute care clinics serve a disproportionate share of medically uninsured and underinsured young children. Additionally, working poor parents are likely to have less work flexibility to take children for routine health care visits, making greater use of off-hour acute care centers and emergency departments instead. Health and social problems come to the attention of acute care and emergency department medical providers that otherwise would be missed.

With leadership from our network of pediatricians and public health researchers, we collect data on children up to the age of four and their families in emergency departments and clinics at Boston Medical Center in Boston; the University of Maryland School of Medicine in Baltimore; Arkansas Children’s Hospital in Little Rock; Hennepin County Medical Center in Minneapolis; and St. Christopher’s Hospital for Children in Philadelphia.  The majority of our sample is made up of families with low incomes.

Learn more about what we have learned by following the links below.  We share our findings in peer reviewed journals and policy publications with policy experts, advocates, legislative leaders and their staff, and the public.  We present our work through national scientific meetings and policy conferences, testimony at hearings, in policy briefings, on webinars and other virtual events, and in the media.

To read our peer-reviewed articles, click here.

To read a summary of our findings, click here.