{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T17:07:48Z","timestamp":1784221668982,"version":"3.55.0"},"reference-count":77,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                    <jats:p>Children experience the highest impact from neighborhood violence (NV) exposure. Timely access to care has proven to mitigate these untoward effects. However, robust, up-to-date information regarding patterns of health care access, including the impact of the COVID-19 pandemic among children exposed to NV, is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We used an annually collected nationally representative survey (National Health Interview Survey) to examine predictors of NV in 2019 to 2023. A residential parent or other adult knowledgeable about the child\u2019s health is selected to respond to questions about the child. We used a time series model to explore the impact of the COVID-19 pandemic on NV. We constructed logistic regression models to predict the patterns of health care access and use (preventive care access, acute care use, and unmet health needs) among children aged 2 to 17\u00a0years exposed to NV and adjusted for potential covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Out of a sample of 29\u2009013 representing a weighted population of 65\u2009140\u2009276 individuals, we found that 1676 children (weighted 3\u2009735\u2009352; 5.8% [95% CI, 5.5\u20136.2]) were exposed to NV from 2019 to 2023. The likelihood of exposure to NV increased significantly in 2022 compared with 2021. Exposure to NV is significantly associated with not having a routine dental examination, increased use of mental health services, increased acute care use, and delayed and forgone medical, dental, and mental health care due to cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>As challenges to prompt access to medical, dental, and mental health care persist among US children, exploring alternative strategies to pediatric health care financing is critical to robust childhood health care coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-071560","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:02:40Z","timestamp":1773360160000},"source":"Crossref","is-referenced-by-count":0,"title":["Health Care Utilization and Neighborhood Violence: 2019\u20132023"],"prefix":"10.1542","volume":"157","author":[{"given":"Oluwatobi Emmanuel","family":"Adegbile","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee"},{"name":"2Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, Tennessee"},{"name":"3Center for Disease Control and Prevention, Cephas Health Research Initiative Inc., Ibadan, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oladipo Kunle","family":"Afolayan","sequence":"additional","affiliation":[{"name":"4Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center in Houston, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nnenna Ann","family":"Ukoha","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee"},{"name":"5Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiana Rachele","family":"Johnson","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, James H. 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