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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Access to care for children of the working poor
1Division of Health Policy and Management, 404 Warren Hall, University of California, Berkeley, Berkeley, CA 94720-7360, USA. sylviag@uclink4.berkeley.edu
Insights
Children in working poor families face significant health care access barriers. Insurance expansions like the Children's Health Insurance Program and Medicaid can help reduce these disparities.
Area of Science:
- Pediatric Health Services Research
- Health Disparities
- Socioeconomic Factors in Health
Background:
- Working poor families often lack essential health resources for their children.
- This scarcity places children at a heightened risk for inadequate healthcare access and utilization.
- Understanding these barriers is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate financial and nonfinancial access to health services for children in working poor families.
- To compare access and utilization patterns with children from nonworking poor and moderate to affluent families.
- To identify specific disparities in healthcare access and needs.
Main Methods:
- Cross-sectional study involving 13,785 children under 18 years.
- Utilized data from the 1997 National Health Interview Survey.
- Assessed insurance coverage, continuity, delayed/unmet care, usual source of care, and healthcare utilization.
Main Results:
- Working poor children had higher uninsured rates (22%) and insurance disruptions compared to other groups.
- Disparities in insurance, delayed care, and unmet needs persisted after adjustments.
- While having a usual source of care, working poor children showed significant differences in structural access and utilization compared to affluent children.
Conclusions:
- Children in working poor families encounter substantial barriers to healthcare access.
- Targeted health insurance expansions, such as through the Children's Health Insurance Program and Medicaid, are vital.
- These programs can mitigate financial and nonfinancial barriers, potentially correcting existing health disparities.
Context:
Recent evidence suggests that children in working poor families lack health resources, placing them at risk for inadequate access to care.
Objectives:
To examine financial and nonfinancial access and utilization of health services among children in working poor families, and to compare these data with those of children from both nonworking poor and moderate to affluent families.
Design:
A cross-sectional study of 13 785 children younger than 18 years.
Participants:
Subjects from the 1997 National Health Interview Survey.
Main Outcome Measures:
Prevalence and continuity of health insurance coverage, of delayed or missed care, and of unmet care needs; presence and type of usual source of care; and the amount of visits to physicians, emergency departments, and hospitals.
Results:
Compared with children of nonworking poor parents and moderate to affluent children, more working poor children were uninsured (22% vs 12% and 5%, respectively; P<.01) and experienced disruptions in insurance coverage (P<.01). After adjusting for other covariates, disparities in insurance coverage and continuity persisted, as did delays in care and unmet care needs; these delays were far higher for the working poor. Although these children had access to a regular source of care and had utilization rates comparable with those of other poor children, they differed markedly from moderate to affluent children on structural access and utilization (adjusted odds ratios, 1.5-3.4).
Conclusions:
Children in working poor families experience far more barriers to care than other children. Health insurance expansions through the Children's Health Insurance Program and Medicaid, which reduce financial and nonfinancial barriers to care, may help correct these disparities.
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