We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Adequacy of Well-Child Care and Immunizations in US Infants Born in 1988

Henry D. Mustin, MD, MPH; Victoria L. Holt, PhD; Frederick A. Connell, MD, MPH
JAMA. 1994;272(14):1111-1115. doi:10.1001/jama.1994.03520140041035.
Text Size: A A A
Published online


Objective.  —To determine adequacy of preventive care for US infants, including both well-child care visits and immunizations, and to identify risk factors for inadequate receipt of care.

Design.  —Analysis of the 1988 National Maternal and Infant Health Survey of the National Center for Health Statistics.

Sample.  —Nationally representative sample of all US children born in 1988.

Participants.  —A total of 7035 infants from a live-birth subsample who were at least 8 months of age and living with their mothers at the time of the survey.

Main Outcome Measures.  —Percentage of children receiving both adequate well-child visits and adequate immunizations by 8 months of age.

Results.  —Adequate visits were received by 82% of white infants and 75% of black infants; adequate immunizations were received by 46% and 34%, respectively. Forty-two percent of white infants and 29% of black infants received both. Sixty percent of infants who did not have adequate immunizations by 8 months of age had at least three well-baby visits. With adjustment for maternal education level, poor white children had a relative risk of 1.5 of receiving inadequate care compared with infants in families with income greater than 185% of the federal poverty level. Infants with Medicaid or other government assistance had significantly lower levels of adequate care than did infants with private insurance.

Conclusions.  —This study demonstrates a wide gap between actual immunization coverage levels and recommended levels among US infants born in 1988. Public health agencies, Medicaid programs, and primary care providers should explore ways to take better advantage of well-child visits that are already occurring to achieve appropriate levels of immunization coverage.(JAMA. 1994;272:1111-1115)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.