For health care to be accessible to children and their families, providers should spend enough time with families, communicate with parents in a language and at a level that they can understand, provide the services of an interpreter when necessary, and explain things clearly. Parents whose children have a personal doctor or nurse were asked whether this doctor or nurse always, usually, sometimes, or never fit this description. Overall, parents of 65.6 percent of children report that their children’s personal doctor or nurse usually or always met this standard of communication and cultural sensitivity; 17.8 percent of children have a personal doctor or nurse whose care does not meet this standard, and 16.7 percent do not have a personal doctor or nurse.

These proportions vary by the race and ethnicity of the child. Among White children, 76.1 percent have a personal doctor or nurse who usually or always communicates in a way they could understand and spent enough time with them, as do 70.2 percent of multiracial children. However, these proportions were much lower among Black children (51.0 percent), Hispanic children (42.8 percent), and children of other races (57.5 percent). Hispanic and Black children were particularly likely to lack a personal doctor or nurse (32.4 percent and 22.9 percent, respectively; data not shown).

A family’s primary language clearly influences their ability to communicate with providers. While parents of 70.1 percent of children who speak English at home report that they have a doctor or nurse who communicates effectively and is sensitive to their culture, only 34.3 percent of children whose primary language is not English have primary providers who meet these criteria for communication and sensitivity. Moreover, children whose families do not speak English at home are more likely than English speakers to lack a personal doctor or nurse: 37.9 percent do not have such a provider, compared to 13.6 percent of English speakers (data not shown).

The reported communication skills and cultural sensitivity of providers appears to vary by a child’s insurance status as well. Of children with private insurance, 74.7 percent have a doctor or nurse who usually or always met the standard of communication and sensitivity described above, compared to 54.4 percent of children with public insurance and 36.0 percent of uninsured children.