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Hours on hold, limited appointments: Why California babies aren't going to the doctor

Jenny Gold, Los Angeles Times on

Published in Health & Fitness

According to state Medi-Cal data from 2021, the most recent year for which detailed data are available, and assessments from health experts, the impact is sobering:

•60% of babies did not get their recommended well-child visits in the first 15 months of life. Access was even worse for Black babies — 75% did not receive their recommended screenings. Children who do not attend their well-child visits are more likely to go to the emergency room and be hospitalized for illnesses like asthma.

•65% of 2-year-olds were not fully vaccinated, leaving them vulnerable to preventable diseases like measles and whooping cough.

•Half of children did not receive a lead screening by their second birthday; families may not know if their homes or other environments are unsafe, which raises the potential for irreversible damage.

•71% of children did not receive their recommended developmental screening in their first three years. Without routine screenings, less than half of children with developmental or behavioral disorders are detected before kindergarten and miss out on early interventions.

"There's a lot that happens in a well-child visit that keeps the child healthy in the immediate and the long term," said Dr. Yasangi Jayasinha, a pediatrician with the Los Angeles County Department of Public Health. A doctor must ensure that a child is growing and developing normally, getting the proper nutrition, and help the family get plugged into other needed resources like food and housing assistance.

 

"No state is perfect, but it is particularly concerning that California isn't at least in the middle of the pack, given its focus on young children and the importance of early brain development," said Elisabeth Wright Burak, who studies child health policy at the Georgetown University McCourt School of Public Policy's Center for Children and Families.

A growing problem

There are myriad reasons for California's poor rates of preventive care for children, according to health experts across the state: a shortage of pediatricians who accept Medi-Cal, especially in rural parts of the state; transportation issues for families who don't have a car; difficulties getting time off work to take a child to a doctor's appointment; a byzantine Medi-Cal bureaucracy that makes coverage difficult to use for patients.

In 2019, a California State Auditor report found that less than half of children with Medi-Cal received their recommended preventive care. The audit blamed low reimbursement rates to Medi-Cal physicians, as well as poor state oversight, and gave the department a list of fixes.

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