Clinical Research Coordinator University of Pittsburgh School of Medicine Toledo, Ohio, United States
Background: A parent’s work precarity, including irregular, unpredictable, or inflexible hours, may limit their children’s ability to attend pediatric visits. Objective: To examine the prevalence of work precarity among a national sample of parents with young children and the association of work precarity with other barriers to care, including transportation and digital barriers. Design/Methods: We developed and fielded a survey to parents of children within a nationally representative panel of US adults in English and Spanish. Survey items inquired about work schedules, transportation barriers, and digital literacy and devices. Parents of children ages 6 months to 5 years old were eligible to participate. Results: Of individuals screened, 40% were eligible to participate. Of those eligible, 95% completed the survey, yielding 944 sample respondents. Among the sample, 339 (36%) had a child insured by Medicaid and 165 (18%) had a child with a chronic medical condition, 518 (55%) identified as white individuals, and 285 (30%) reported speaking a language other than English at home. Regarding work barriers, 21% of respondents reported it was very difficult or somewhat difficult to take off work to take care of personal or family matters, 21% reported knowing their work schedule less than 7 days advance, and 28% reported that their work schedule each week was decided without their input. Regarding transportation barriers, 15% reported it was very difficult or somewhat difficult to get to their child’s usual source of care, 14% of respondents reported that lack of transportation kept them from medical care, and 9% reported greater than 1 hour travel time to their child’s usual source of care. Difficulty traveling to their child’s usual source of care was more common for those who reported it was difficult to take off work (29%) than those who reported it was not difficult (11%, p< 0.001). Regarding digital barriers, 53% reported optimal digital health literacy on the Digital Health Literacy Scale. 91% reported smartphone ownership, 75% reported laptop or desktop ownership, 86% reported a cellular data plan, and 70% reported broadband internet. Less than optimal digital health literacy was more common for those who reported it was difficult to take off work (61%) than those who reported it was not difficult (45%, p< 0.001).
Conclusion(s): One-fifth to one-quarter of parents of young children reported at least one dimension of work precarity. Parents with work precarity were also more likely to report transportation barriers and sub-optimal digital health literacy, compounding the difficulty of attending health care.
