Children with special health care needs (SHCN) face poorer access to and quality of health care than children without SHCN, leading to greater unmet health care needs. Chronic pain, a common comorbidity of chronic conditions, is associated with greater risk for poor physical and psychological functioning and increased health care utilization. However, little is known about chronic pain in children with SHCN and unmet health care needs in this population. Secondary analysis of the 2022 National Survey of Children’s Health (NSCH), a nationally representative survey of youth aged 0–17, was conducted. SHCN status, chronic pain presence, and the presence of and reasons for unmet health care needs were assessed. Models were adjusted for demographic and socioeconomic factors. Among all 52,713 participants, 12,762 (21%) had SHCN, and 2806 (5.5%) reported chronic pain. Children with SHCN experienced a higher prevalence of chronic pain (14.0%) than those without SHCN (3.2%). Greater odds of unmet health care needs were associated with chronic pain; odds further increased among children with both SHCN and chronic pain. Commonly reported barriers to health care included problems getting an appointment, services not available in the area, and the office not being open when the child needed care. Children with SHCN are disproportionately affected by chronic pain, which is strongly associated with increased unmet health care needs. Reported barriers primarily reflected issues with access to and availability of services. Enhancing access to pediatric pain management services may help reduce these disparities and improve health outcomes in this population.
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