2025 Children's of Alabmama Community Health Needs Assessment

Across all other categories, geography is the differentiator. Those in the Birmingham MSA or urban areas emphasize the ability to pay. In contrast, those in the non-Birmingham MSA or rural areas emphasize the availability of quality care. Lack of reliable transportation is the top issue reported by healthcare professionals.

Table 13. Access Issues by Geography Category

n Issue

Mean

Birmingham MSA

427 Ability to pay for care

2.6

Outside the Birmingham MSA

324 Availability of quality healthcare services 2.6

Urban

526 Ability to pay for care

2.6

Rural

225 Availability of quality healthcare services 2.1

Parent of a minor child

390 Ability to pay for care 346 Ability to pay for care

2.6 2.7

Not the parent of a minor child

Healthcare Professional

403 Lack of reliable, affordable transportation 2.9

Educator

77 Ability to pay for care 263 Ability to pay for care 553 Ability to pay for care 79 Ability to pay for care

2.6 2.4 2.8 2.1

Other professional role Works with children

Does not work with children

SURVEY RESPONSES COMPARED TO EXTERNAL DATA

Primary care providers(PCPs) are closed on Fridays. After-hours care means a trip to Tuscaloosa or Meridian. Some families pay for an air-evacuation plan. – Pickens County focus group highlights Respondents identified availability of quality services, ability to pay, and availability of care as the most significant access problems, with each of those options ranked the #1 barrier by roughly one-quarter of respondents. Other notable access issues were parent education (lack of knowledge about health resources), cited as the top barrier by 21% of respondents, and transportation, cited by 16%.

Scheduling difficulties (such as long wait times or inconvenient clinic hours) were a lesser but present concern: 8% ranked it #1.

These community perceptions paint a picture of two core access challenges: infrastructure resource gaps (not enough providers/ services, especially specialized care) and financial/personal barriers (cost, lack of information, logistics for families).

Objective measures strongly confirm these access challenges in Alabama. As noted, health insurance coverage for children is high.

Only 3.3% of Alabama children are uninsured. 24 As discussed in the previous section, however, coverage does not equal access. Many insured children still struggle to get care due to provider shortages and other barriers. Alabama’s pediatric care infrastructure is uneven. Urban centers such as Birmingham and Mobile have pediatric hospitals and specialists, but large swaths of the state have very few or no local pediatric providers. According to a VOICES for Alabama’s Children analysis, healthcare access in rural counties is not only sparse but also declining—hospital and clinic closures have left “pediatric deserts.” For example, more than 80% of Alabama’s counties lack a pediatric subspecialist, and several rural counties have no practicing pediatrician at all. In 13 counties, the ratio of child population to pediatric providers is effectively 100,000:1 (meaning almost no pediatric doctors. 25 This is borne on by survey respondents, recognizing that the nearest pediatric specialists or mental health services could be hours away.

______________________________________ 24 Alabama Profile” 2024 Kids Count Data Book. Voices for Alabama’s Children. https://alavoices.org/wp-content/uploads/2025/03/Alabama_Profile.pdf#:~ text=Children%20in%20Foster%20Care%20Base,2023%207%2C349%202%2C837 25 Covered but Not Cared For: Identifying Pediatric Deserts in Alabama and Interventions to Affect Change. Voices for Alabama’s Children. March 2020. https://alavoices. org/wp-content/uploads/2020/03/Pediatric-Deserts.pdf#:~:text=the%20data%20and%20determine%20which,to%20public%20health%20venues%20like

Children’s of Alabama, 2025 CHNA

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