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This study is the first of its kind to comprehensively assess health and health care use among the more than 100,000 youth residing in Washington, D.C., considering both the children's health service delivery system and the communities where they live, which affect their health. The authors use survey, administrative, and focus group data to describe the health status of District children and their use of health services, with particular attention to changes over time in health status and health care use as well as differences by age, insurance status, and location within the city; assess environmental characteristics that may contribute to or ameliorate poor health outcomes among children; describe community resident and provider perspectives on child health service needs; and consider the implications of the evidence they synthesize for improving children's health in the District. The goal of the study is to lay a factual foundation for advocacy and policy decisions related to children's health in the District, as well as to help inform the allocation of community benefit resources by Children's National Medical Center, a children's hospital in the District.

The research described in this report was supported by the Children's National Medical Center and conducted within RAND Health.

This report is part of the RAND technical report series. RAND technical reports may include research findings on a specific topic that is limited in scope or intended for a narrow audience; present discussions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; or deliver preliminary findings. All RAND reports undergo rigorous peer review to ensure that they meet high standards for research quality and objectivity.

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