Spotlight on Children With Special Needs (Part 2): Who Are California’s Children With Special Health Care Needs?

Doctor holding hand of smiling child patient.

The second in our series on children with special health care needs (CSHCN) explores key demographic and health characteristics of CSHCN in California. Read the first in our series, on access to family-centered care for CSHCN families, here.

In 2022, an estimated 16% of California children ages 17 and under had special health care needs. This means that nearly 1.4 million of the state’s youngest residents had or were at increased risk for a chronic physical, developmental, behavioral, or emotional condition and required related services beyond what’s required by children generally. The ongoing health challenges facing children with special health care needs (CSHCN) can affect their ability to function and participate in important educational and social activities; in some cases, the challenges can shorten their lives.

What do existing data tell us about these children? Here are five things you should know about California’s CSHCN:

1. CSHCN are more likely to have multiple adverse childhood experiences than their peers. The share of CSHCN in California who have experienced four or more adverse childhood experiences (ACEs) is more than five times that of children without special health care needs. These experiences can disrupt healthy development and lead to behavioral, emotional, academic, and health problems throughout life. The more traumatic childhood events experienced, the more likely the impact will be substantial and long lasting, especially if the child does not receive the right support in the aftermath.

2. Parents of CSHCN are less likely to report that their children are resilient when faced with challenges. Resilience may help mitigate the harmful effects of ACEs and toxic stress in children. But just under half of CSHCN in California were described by their parents as resilient—meaning they usually or always stay calm and in control when faced with challenges—compared to 80% of children without special health care needs.

3. Mental health conditions are more common among CSHCN. According to 2022 data from the National Survey of Children’s Health, 51% of California CSHCN ages 3 to 17 had one or more diagnosed mental health conditions—attention deficit disorder or attention-deficit/hyperactivity disorder, anxiety problems, behavioral or conduct problems, or depression—compared with just over 5% of their peers without special health care needs.

4. Most CSHCN have complex health care needs, including multiple chronic conditions, requiring in-depth services and treatment. In California, over three-quarters (77%) of CSHCN had complex health care needs in 2022, with 65% having more than one chronic condition and 27% having more than three.

5. While the share of CSHCN in middle- and higher-income families is above the national average, racial and ethnic disparities exist. Nearly one-third of CSHCN in California had a 2021 family income of at least 400% of the poverty threshold (i.e., $109,916 for a family of two adults and two children), compared with just over one-quarter of CSHCN nationally. Yet just one-fifth of Hispanic or Latino children, who comprise about half of the state’s CSHCN, live in families with this income level, and Hispanic or Latino CSHCN are more likely to live just above the poverty threshold than in other income brackets. On the other hand, while white children comprise less than one-third of the state’s CSHCN, more than half of them live in families with incomes at or above 400% of the poverty threshold.

Read about how we can support California CSHCN and their families.

Funding for KidsData’s latest information on CSHCN is provided by the Lucile Packard Foundation for Children’s Health.

We Want to Hear From You

Closing Tomorrow: KidsData User Survey 2024

How do you use KidsData data and resources? What could we do differently? We want to hear from you about how we can improve our offerings to better support your efforts on behalf of children and families. Please consider taking 10 minutes to share your thoughts in our user survey. The survey closes this Friday, March 29.


2024 Santa Clara County Children’s Summit

The Santa Clara County Children’s Summit, presented by Kids in Common on April 19 from 9:30 a.m. to 3:30 p.m. PDT, gathers cross-sector and young leaders to connect and collaborate in improving the well-being of the county’s children. This year’s theme, “Cultivating Caring Communities,” marks the launch of initiatives aimed at boosting the social-emotional health of children, youth, and families, offering attendees the opportunity to learn from experts and strategize on advancing this critical aspect within their communities. Register here.

Children’s Health Resource

Measuring Student Safety: New Data on Bullying Rates at School

About 19% of students in the United States reported being bullied during the 2021–22 school year. A new release by the National Center for Education Statistics uses data from the School Crime Supplement to the National Crime Victimization Survey to highlight recent bullying victimization in U.S. schools.

Recently Released

We recently released data about characteristics of children with special health care needs. See links to the latest here.

Posted by

This entry was posted on Thursday, March 28th, 2024 at 10:07 am. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

Post a comment/question: