Millions of US Children Do Not Receive Key Health Care Preventive Services

Dr. Lorraine Yeung Division of Birth Defects and Developmental Disabilities National Center on Birth Defects and Developmental Disabilities, Interview with:
Dr. Lorraine Yeung
Division of Birth Defects and Developmental Disabilities
National Center on Birth Defects and Developmental Disabilities, CDC

Medical Research: What are the main findings of the study?

Dr. Yeung: In this report, we looked at the percentages of children who received various recommended clinical preventive services. We found that millions of infants, children, and adolescents in the U.S. did not receive key clinical preventive services.

This report provides a baseline snapshot of the use of 11 key clinical preventive services before or shortly after the Affordable Care Act went into effect. A focus of the Affordable Care Act is on improving prevention of illness and disability and it does so by requiring new health insurance plans to provide certain clinical preventive services at no additional cost — with no copays or deductibles. This is important because we know increasing the use of these services can improve children’s health and promote healthy lifestyles that will enable them to reach their full potential.

Some of the important findings in this report were:

         In 2007, parents of almost eight in 10 (79 percent) children aged 10-47 months reported that they were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.

         In 2009, more than half (56 percent) of children and adolescents did not visit the dentist in the past year and nearly nine of 10 (86 percent) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.

         Nearly half (47 percent) of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.

         Approximately one in three (31 percent) outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; eight of 10 (80 percent) of those who screened positive for tobacco use did not receive any cessation assistance.

         Approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement.

Medical Research: What was most surprising about the results?

Dr. Yeung:

Dr. Yeung: Based on previous work by others, we know that these services are underused. And because of that, they met our selection criteria so they were included in our report.

However, the fact that millions of infants, children, and adolescents did not receive important preventive care is a wakeup call to all of us that we need to protect our children’s health and ensure that they receive the recommended screenings and services.

Medical Research: What should clinicians and patients take away from your report?

Dr. Yeung: Together, parents and the public health and healthcare community can work together to ensure children receive clinical preventive services.

Healthcare providers can become aware of new and existing clinical preventive services guidelines and incorporate them into their practices. They can also inform parents about the benefits of preventive services and offer recommended clinical preventive services as a routine part of care. They can adopt and use certified electronic health records and personal health records, as well as create linkages with and connect patients to community resources.

Parents can familiarize themselves with the services their children need yearly. CDC has launched a new website,, where parents will be able to find this information quickly.  It’s also important for parents to continue to bring their children to the doctor for well-child visits and make sure they’re getting the recommended services for their age.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Yeung: CDC will continue to collect data on the use of clinical preventive services and will analyze the information at a later date to see how things have changed.

We could not include several clinical preventive services in our report (for example, obesity screening and alcohol screening) due to lack of national data so it would be helpful to have national data for these services. In addition, more data are needed to continue to build the evidence-base for recommending the use of additional clinical preventive services.


Rationale for Periodic Reporting on the Use of Selected Clinical  Preventive Services to Improve the Health of Infants, Children, and Adolescents — United States
 Morbidity and Mortality Weekly Report (MMWR)
September 12, 2014 / 63(02);3-13
Centers for Disease Control and Prevention



Last Updated on September 30, 2014 by Marie Benz MD FAAD