As the economy continues to falter, a new poll shows that parents must make harder choices about how to spend what money they have, and children - especially those who are uninsured or who are among the lowest income bracket - are more at risk because of it.

The C.S. Mott Children's Hospital National Poll on Children's Health taken in May 2009 shows 44 percent of families' financial situations have worsened in the last six months. To make ends meet, many have cut back on extras (65 percent), applied for government health coverage (24 percent), applied for free or reduced lunch programs (27 percent), and delayed taking their children to the doctor (11 percent) or dentist (16 percent).

"In particular, we found that if a family's financial situation had worsened over the last 6 months and their children were uninsured, 40 percent of those parents had delayed taking their children to the doctor," says Matthew Davis, M.D., director of the poll. "This is a particularly concerning statistic when we consider that some of these kids whose care is being delayed may be particularly vulnerable or at risk for serious health problems."

The poll also showed that 40 percent of parents indicate their children ages 5 - 17 have some or a lot of stress as a result of worries about their family's finances. Fifty-three percent of parents report their teens, ages 13 - 17, have stress due to the family's financial situation.

Common symptoms of stress in children include acting out, abdominal pain and headaches.

"We found that stress from financial worries affected families of lower incomes more than families of higher incomes," says Davis, who is associate professor of pediatrics, internal medicine, and public policy at the University of Michigan Medical School and Gerald R. Ford School of Public Policy. "So much so that families of the lowest income level - namely making $30,000 per year or less - were more than twice as likely to report their kids had stress as families of the highest income group making $100,000 or more per year."

The National Poll on Children's Health also finds:

- Among parents with children age 17 or younger, 39 percent said their financial situation stayed the same and 17 percent said it got better.

- Parents report their children show signs of stress due to financial worries as 56 percent of parents making less than $30,000; 44 percent of parents making $30,000 - $60,000; 30 percent of parents making $60,001 - $100,000; and 25 percent of parents making $100,000 or more.

"Overall, the findings indicate that this recession is not an equal opportunity recession," says Davis, "It has affected families across all income levels and range of vulnerability, but it is affecting those who are most vulnerable even more than the population as a whole. If you don't have insurance, or if your family income is at a lower level, your children are likely to be even at higher risk as this recession drags on."