Homeschoolers and Health Care

This post reviews Alissa Cordner, “The Health Care Access and Utilization of Homeschooled Children in the United States” in Social Science and Medicine 75 (2012): 269-273.

Cordner, a graduate student in sociology at Brown University, here offers her first foray into homeschooling research.  She used the 2007 National Survey of Children’s Health (NSCH), a government phone survey of over 91,000 households randomly sampled from the national population.  The NSCH asked families about the kind of schooling the child being reported on attended, including homeschooling, so Cordner’s got great data from which to draw conclusions.

Cordner’s analysis looked at the 61,784 interviews recorded by NSCH with families with children ages 6 to 17. Of this group of children, 1470 (2.38%) were homeschooled.  She compared them to the much larger group of public schooled children (52,429 or 84.86%), and separately compared students attending private schools or who reported no schooling to public school children.  Rates of health insurance were high for all groups of children: 89.9% of public school children, 90.4% of homeschooled children, and 94.5% of private school children have health insurance of some kind.

Cordner’s homeschooled sample sounds a lot like what one would expect.  It was 80% white, with well educated parents, large families, and high levels of religious observance.  Despite this positive demographic profile (positive in the sense that middle class white children in stable families tend to have excellent health care), these homeschooled children, when background variables were controlled, were significantly less likely than public schooled children to receive an annual check up and far less likely to receive the controversial HPV vaccine.  They were not less likely to receive dental care and only very slightly less likely to get a tetanus shot or the meningitis vaccine.  Cordner summarizes,

Homeschooled children are disproportionately White and come from educated, two-parent families with three or more children, traits generally associated with higher access to and utilization of health care services. This highlights the significance of these findings. (p. 272)

Why are homeschoolers less likely to receive medical care but not dental care?  Cordner speculates,

An avoidance of vaccinations by homeschooling families, and by extension visits to doctors for preventive care including vaccinations, may be connected to their identified distrust of the health care system or the government…, or a desire to avoid questioning by physicians regarding vaccination decisions. (p. 272)

Cordner concludes by stating that the NHCS’s reliance on parental self-reporting through land-line phone interviews perhaps undercounts homeschoolers, some of whom would likely refuse to participate in such a survey.  And those who refused are probably just the sort who might also be distrustful of vaccines and of medical expertise in general.  Noting that several states permit homeschoolers not to participate in vaccination programs, she worries what the overall impact of this policy might be on the health both of homeschoolers and of the general public.  She’d like to see the same health care rules followed by public schools followed by homeschoolers as well.  She also calls for more, especially qualitative research on the phenomenon to see if her speculations here are warranted.

I don’t have anything really to say about this article.  It’s a straightforward presentation of figures from a huge dataset, previously untapped by homeschooling researchers.  I wonder if other researchers might take a look at this data and find more interesting material?  Random sampling is very rare in homeschooling research, and that makes this NSCH data quite valuable.  Readers who want more on the vaccination issue can find other reviews I’ve done under the category to the right labeled “Homeschooling and Health.”

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