Poverty, insurance, and well-baby care among mainland Puerto Rican children

Using data from the Puerto Rican Maternal and Infant Health Study, we investigate the implications of family income and insurance status for well-baby care among mainland Puerto Ricans. Given the socioeconomic disadvantage of Puerto Ricans, it is critical to understand the extent to which low income and lack of health insurance create barriers to well-baby care and result in low utilization. The analysis shows that the income-to-needs ratio is related to barriers to well-baby care, and a key intervening factor is insurance status. The odds of reporting any barriers to care are lowest among those with both adequate income and private health insurance. Access to insurance is also vital in achieving adequate well-baby care. Uninsured children receive inadequate care more often than children with public or private insurance, especially when their income is also low. Children with public insurance are as likely as children with private insurance to receive an adequate number of well-baby visits, despite the fact that their mothers report more barriers to care.