Lindsey I Black’s research while affiliated with Centers for Disease Control and Prevention and other places


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Publications (38)


Perceived Social and Emotional Support Among Teenagers: United States, July 2021-December 2022
  • Article

July 2024

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2 Reads

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Lindsey I Black

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Stephen J Blumberg


An Expanded Approach to the Ascertainment of Children and Youth With Special Health Care Needs

May 2024

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13 Reads

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1 Citation

PEDIATRICS

OBJECTIVE To describe the prevalence, characteristics, and health-related outcomes of children with diagnosed health conditions and functional difficulties who do not meet criteria for having a special health care need based on the traditional scoring of the Children with Special Health Care Needs (CSHCN) Screener. METHODS Data come from the 2016 to 2021 National Survey of Children’s Health (n = 225 443). Child characteristics and health-related outcomes were compared among 4 mutually exclusive groups defined by CSHCN Screener criteria and the presence of both conditions and difficulties. RESULTS Among children who do not qualify as children and youth with special health care needs (CYSHCN) on the CSHCN Screener, 6.8% had ≥1 condition and ≥1 difficulty. These children were more likely than CYSHCN to be younger, female, Hispanic, uninsured, privately insured, living in a household with low educational attainment, have families with more children and a primary household language other than English. After adjustment, non-CYSHCN with ≥1 conditions and ≥1 difficulty were less likely than CYSHCN, but significantly more likely than other non-CYSHCN, to have ≥2 emergency department visits, have unmet health care needs, not meet flourishing criteria, live in families that experienced child health-related employment impacts and frustration accessing services. Including these children in the calculation of CYSHCN prevalence increases the national estimate from 19.1% to 24.6%. CONCLUSIONS Approximately 4 million children have both a diagnosed health condition and functional difficulties but are not identified as CYSHCN. An expanded approach to identify CYSHCN may better align program and policy with population needs.


Stressful Life Events and Healthcare Utilization Among U.S. Children Aged 2-17 Years

August 2023

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12 Reads

Objective-Associations between stressful life events (SLEs) during childhood and suboptimal healthcare access and use has been documented. Recent changes to the National Health Interview Survey's questionnaire enabled the inclusion of SLEs in the child sample, resulting in an additional national data source where SLEs can be tracked. In this report, the latest SLE estimates are examined for children aged 2-17 years in the United States and their associations with healthcare utilization. Methods-Data from the 2021 National Health Interview Survey were used to examine the percentage of children who experienced one or more SLEs-emotional abuse, unmet basic needs, experiences of racism, household mental illness, household substance abuse, parental incarceration, and exposure to neighborhood violence-and describe the association between SLEs and selected healthcare utilization indicators over the past 12 months (as in no well-child visit, emergency room visits, urgent care visits, unmet medical care needs due to cost, use of prescription medications for mental health, and use of any mental health therapy). Multivariate logistic regression models were fit to produce prevalence ratios for selected healthcare utilization indicators by SLEs, after adjusting for child and family sociodemographic characteristics. Results-In 2021, one in five children aged 2-17 years had ever experienced an SLE. In general, all SLEs were related to higher healthcare utilization (as in emergency department visits or mental health therapy) and unmet medical care needs. In general, no significant associations were found between experiencing SLEs and not receiving preventive health care. After adjusting for demographic characteristics, higher rates of healthcare utilization, unmet medical care needs, and mental healthcare utilization generally persisted for children with SLEs. Conclusion-This report expands knowledge on the relationship between childhood SLEs and the use of preventive care, healthcare utilization, and mental health care. National Health Interview Survey data can be used to monitor trends in these associations over time.


Diagnosed Developmental Disabilities in Children Aged 3-17 Years: United States, 2019-2021
  • Article
  • Full-text available

July 2023

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52 Reads

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19 Citations

NCHS data brief

Developmental disabilities are common in children in the United States, and the prevalence has increased in recent years (1). Timely estimates are necessary to assess the adequacy of services and interventions that children with developmental disabilities typically need (2). This report provides updated prevalence estimates for diagnosed autism spectrum disorder, intellectual disability, and other developmental delay among children aged 3-17 years from the 2019-2021 National Health Interview Survey (NHIS), with differences in prevalence examined between years and by sex, age group, and race and Hispanic origin. Estimates are also presented for any developmental disability, defined as having had one or more of these three diagnoses.

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Diagnosed Allergic Conditions in Children Aged 0-17 Years: United States, 2021

January 2023

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14 Reads

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29 Citations

NCHS data brief

The percentage of children with certain allergic conditions has increased over previous decades (1,2). Seasonal allergies, which includes hay fever, allergic rhinitis, and allergic conjunctivitis, causes sneezing, cough, runny nose, and itchy eyes. Eczema, also known as atopic dermatitis, causes itchy, bumpy rashes and thickened skin that can appear anywhere on the body. Food allergies can cause hives, vomiting, trouble breathing, or throat tightening. Children with allergic conditions may have increased healthcare use and decreased quality of life (3). Food allergies can be life threatening (4). This report describes the percentage of children who had diagnosed seasonal allergy, eczema, or food allergy by sex, age, and race and Hispanic origin from the 2021 National Health Interview Survey (NHIS).


Assessing the Validity of the Baby Pediatric Symptom Checklist Using a Nationally Representative Household Survey

November 2022

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14 Reads

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3 Citations

Academic Pediatrics

Objective The Baby Pediatric Symptom Checklist (BPSC) is a screening tool developed for detecting behavioral or emotional concerns among parents of children younger than 18 months. Nationally representative survey data have not yet been used to assess the validity of the BPSC, nor to evaluate its appropriateness for use among children between 18 and 23 months old. The current study assesses the validity of the BPSC using data from the National Health Interview Survey (NHIS). Methods Data from the 2019 NHIS were used to evaluate the 12-item BPSC screening tool among a nationally representative sample of children 2-23 months. Confirmatory factor analysis (CFA) and differential item functioning (DIF) were used to assess construct and predictive validity and test how response items differed by selected sociodemographics. Quantile regression was used to calculate 50th, 70th, and 90th percentiles for age-based normative curves of the previously established domains of irritability, inflexibility, and difficulty with routines. Results A three-factor CFA produced comparable results to the original study. Tests of DIF did not reveal any significant effects for the child's sex, race and Hispanic origin, household urbanization level, number of children in family, or respondent type (mother, father, other). In addition, DIF was not found between children aged 2-17 months and 18-23 months. Age-based normative data were calculated for each subscale. Conclusions The use of the BPSC in a nationally representative survey produced findings comparable to those of the original-validation study. The NHIS can be used to track BPSC scores over time at the population-level.


Anxiety and depression symptoms among children before and during the COVID-19 pandemic

September 2022

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24 Reads

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13 Citations

Annals of Epidemiology

Purpose The COVID-19 pandemic caused disruptions to children's daily lives due in part to stay-at-home orders and school closures, reducing interactions with both peers and extended family. Yet, few studies with nationally representative data have explored the potential association of the COVID-19 pandemic and children's mental health. Methods The current study analyzed data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe changes in the prevalence of symptoms of anxiety and depression before and during the first year of the pandemic among children aged 5-17 years. Changes in prevalence by child- and family-level characteristics were also examined. Results During the COVID-19 pandemic, nearly one in six children aged 5-17 years had daily or weekly symptoms of anxiety or depression, a significant increase from before the COVID-pandemic (16.7% (95% CI:15.0-18.6) vs. 14.4% (95% CI:13.4-15.3)). Males, children 5-11 years, non-Hispanic children, children living in families in large metropolitan areas, incomes at or below the federal poverty level, and whose highest educated parent had more than a HS education, also showed statistically significant increases in anxiety and depression symptoms. Conclusions NHIS data may be used to monitor this increase in mental health symptomatology and assist in identifying children at risk.


Organized Sports Participation Among Children Aged 6-17 Years: United States, 2020

August 2022

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53 Reads

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15 Citations

NCHS data brief

Sports team participation has been associated with increased levels of physical activity (1) and improved physical and mental health among children and adolescents (2,3). Disparities in sports participation have been found across age, sex, race, disability, and socioeconomic subgroups (4-6). This report describes national estimates of parent-reported organized sports participation during the past 12 months among children aged 6-17 years. Data from the 2020 National Health Interview Survey (NHIS) are analyzed by sociodemographic characteristics.


Figure 1. Percent distribution of how often school-aged children (5-17 years) had a regular bedtime in a typical school week: United States, 2020
Regular Bedtimes Among Children Aged 5-17 Years: United States, 2020

June 2022

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19 Reads

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3 Citations

NCHS data brief

The American Academy of Sleep Medicine recommends 9-12 hours of sleep for children aged 6-12 years and 8-10 hours for those aged 13-18 (1), yet only two-thirds of children meet these recommendations (2). This report uses 2020 National Health Interview Survey (NHIS) data to describe regular bedtimes, defined as going to sleep at the same time most days or every day in a typical school week, among children aged 5-17 years. Estimates are presented by sociodemographic characteristics, family type, Social Vulnerability Index (SVI), family income, and urbanicity of residence.


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Citations (30)


... As of 2021, 8.56% of children in the U.S. have a neurodevelopmental disorder (NDD), including autism spectrum disorder (ASD), intellectual disability (ID), and attentiondeficit/hyperactivity disorder (ADHD). 1,2 Recognizing factors that predispose individuals to NDDs and enhancing early detection can lead to interventions that reduce the severity of NDD symptoms and improve the quality of life for neurodivergent individuals and their families. 3 Furthermore, timely interventions can help prevent the progression of these conditions into other severe mental or medical complications in adulthood. ...

Reference:

Association of Parental Prenatal Mental Health on Offspring Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis
Diagnosed Developmental Disabilities in Children Aged 3-17 Years: United States, 2019-2021

NCHS data brief

... As a common lung disease caused by swelling and narrowing of the tubes that carry air in and out of the lungs, asthma stands as a prevalent chronic ailment affecting children globally [2]. The global prevalence of allergic diseases and asthma were steadily increasing, with a notable rise in the complexity and severity, particularly among children and young adults, which have a reduced quality of life [3,4]. These upward trends in allergic diseases and asthma had also led to a growing socioeconomic burden worldwide. ...

Diagnosed Allergic Conditions in Children Aged 0-17 Years: United States, 2021
  • Citing Article
  • January 2023

NCHS data brief

... The BPSC is a brief instrument for the assessment of socioemotional difficulties in children under 18 months of age. The BPSC consists of 12 items distributed across three dimensions: "irritability", "inflexibility", and "difficulties with routines" [66]. The "irritability" dimension evaluates the caregiver's perception of their child's tendency to cry often, take a long time to calm down, or display frequent irritability. ...

Assessing the Validity of the Baby Pediatric Symptom Checklist Using a Nationally Representative Household Survey
  • Citing Article
  • November 2022

Academic Pediatrics

... Given the increased prevalence of mental health needs among youth, [43][44][45][46][47][48] it is concerning that specialty outpatient mental health rates were lower among youth with new mental health needs, compared to the pre-PHE population. These enrollees might have struggled to adopt telehealth for several reasons. ...

Anxiety and depression symptoms among children before and during the COVID-19 pandemic
  • Citing Article
  • September 2022

Annals of Epidemiology

... The decline of PA (Do et al., 2022;Dunton et al., 2020) and sports participation (Post et al., 2022;Watson & Koontz, 2021) have been recognised as a growing public health concern, and the outbreak of COVID-19 pandemic and concomitant shutdown has exacerbated these observed declines (Schmidt et al., 2020;Watson & Koontz, 2021). Chaffee et al. (2021) found that about half (52%) of U.S. adolescents stopped being physically active following stay-at-home orders, and Black et al. (2022) reported that just over one-half of children aged 6-17 years (54.1%) participated in sports during the past 12 months in 2020. ...

Organized Sports Participation Among Children Aged 6-17 Years: United States, 2020
  • Citing Article
  • August 2022

NCHS data brief

... A su vez, las recomendaciones del tiempo recomendado de sueño aportadas por la Academia Americana de Medicina del Sueño, avaladas por la Academia Americana de Pediatría (Moon et al., 2022), son de 9 a 12 horas por día para niños entre 6-12 años y de entre 13-18 años para adolescentes. La duración del sueño disminuye con la edad, sin embargo, la calidad del sueño puede mejorar con el paso de los años, por lo que estudios encaminados a monitorear los patrones de sueño deberían realizarse mediante actigrafía y polisomnografía en el domicilio (Adjaye-Gbewonyo et al., 2022;Galland et al., 2018;Hamilton et al., 2023;Stores y Crawford, 1998). Además, los valores de duración y calidad de sueño en niños y adolescentes pueden verse afectados significativamente por factores demográficos, sociales y/o ambientales (Larrinaga-Undabarrena et al., 2023). ...

Regular Bedtimes Among Children Aged 5-17 Years: United States, 2020

NCHS data brief

... When sleep disruptions occur, the impacts are farreaching and can contribute to a variety of health consequences, including increased risk of cardiovascular disease, metabolic dysregulation, and psychosocial stress. 1 Sleep difficulties are ubiquitous, with 14.5% of American adults in the 2020 National Health Interview Survey reporting trouble falling asleep on most or all nights within a given month. 2 The complexity of sleep's relationship to all aspects of a person's life has led to the development of the concept of "somnomics" as part of the precision medicine toolbox, 3 which also houses genomics, proteomics, and personomics. 4 ...

Sleep Difficulties in Adults: United States, 2020

NCHS data brief

... Asthma affects approximately 10% of the global pediatric population, while attentiondeficit hyperactivity disorder (ADHD) prevalence is around 10% in regions like the United States and China [1][2][3]. However, these rates can vary depending on cultural, geographical, and age-related factors [4]. ...

Mental Health Surveillance Among Children - United States, 2013-2019
  • Citing Article
  • February 2022

MMWR Supplements

... Mild traumatic brain injury (mTBI), also known as concussion, is a common injury in the pediatric population. In 2014, children aged 0 to 19 made up 32% (812,000) of the 2.5 million TBI-related emergency department visits in the United States, which does not reflect the much higher number of children with a brain injury who do not present to medical centers (Black & Zablotsky, 2021). Similar to psychiatric diagnoses, a diagnosis of mTBI/concussion is made using clinical features and symptoms that are classified under cognitive, affective, and somatic domains, with none of the symptoms pathognomonic for TBI. ...

Concussions and Brain Injuries in Children: United States, 2020
  • Citing Article
  • December 2021

NCHS data brief

... In another study, researchers using the National Health Interview Survey of children, ages ≥ 1 to < 18 years, determined 80.9% of children had a dental examination/prophylaxis in the past 12 months. 25 In terms of comparisons for pediatric general anxiety levels, our results compare with other studies. In our study, general anxiety levels were high (33.1%) ...

Dental Care Utilization Among Children Aged 1-17 Years: United States, 2019 and 2020

NCHS data brief