State-level income inequality and family burden of US families raising children with special health care needs

▸ State-level income inequality is associated with financial burden for low-income families of US children with disabilities. ▸ Low-income families living in high-inequality states spend more in absolute terms on their children's care. ▸ Families living in higher-inequality states are more likely to stop work and receive no help coordinating care than others. ▸ Low-income families in states with unequal income distributions incur greater costs relative to total family earnings. ▸ The relationship between inequality and financial burden is robust, net of child's functional limitations and family factors.