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Updated: Aug 18, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Health insurance status and ambulatory care for children
J J Stoddard1, R F St Peter, P W Newacheck
1Department of Pediatrics, University of Wisconsin Medical School, Madison 53792-4116.
Insights
Uninsured children are significantly less likely to see a doctor for common conditions like earaches or asthma. This lack of timely medical care increases their risk of avoidable illness.
Area of Science:
- Pediatric Health Services Research
- Health Economics
- Public Health Policy
Background:
- A significant number of children in the U.S. lack health insurance coverage.
- Uninsured children may face barriers to accessing necessary medical care.
- This study investigates disparities in physician visits for common childhood conditions based on insurance status.
Purpose of the Study:
- To test the hypothesis that uninsured children are less likely to receive physician care for indicated conditions compared to insured children.
- To quantify the association between lack of health insurance and physician utilization for specific pediatric illnesses.
Main Methods:
- Analysis of data from the 1987 National Medical Expenditures Survey (NMES).
- Focus on a subsample of 7578 children and adolescents (1-17 years).
- Examined physician visit rates for pharyngitis, acute earache, recurrent ear infections, and asthma, controlling for demographic and socioeconomic factors.
Main Results:
- Uninsured children had higher odds of receiving no physician care for all four studied conditions.
- Adjusted odds ratios indicated uninsured children were significantly more likely to forgo physician visits for pharyngitis, acute earache, recurrent ear infections, and asthma.
- Confidence intervals for adjusted odds ratios did not include 1, confirming statistical significance.
Conclusions:
- Children without health insurance are less likely to receive indicated medical care from a physician.
- Lack of insurance places children at increased risk for preventable and significant morbidity.
- Findings underscore the importance of health insurance for ensuring timely pediatric healthcare access.
Background:
Many children in the United States lack health insurance. We tested the hypothesis that these children are less likely than children with insurance to visit a physician when they have specific conditions for which care is considered to be indicated.
Methods:
We examined the association between whether children were covered by health insurance and whether they received medical attention from a physician for pharyngitis, acute earache, recurrent ear infections, or asthma. Data were obtained on the subsample of 7578 children and adolescents 1 through 17 years of age who were included in the 1987 National Medical Expenditures Survey, a national probability sample of the civilian, noninstitutionalized population.
Results:
Uninsured children were more likely than children with health insurance to receive no care from a physician for all four conditions (unadjusted odds ratios, 2.38 for pharyngitis; 2.04 for acute earache; 2.84 for recurrent ear infections; and 1.87 for asthma). Multiple logistic-regression analysis was subsequently used to control for age, sex, family size, race or ethnic group, region of the country, place of residence (rural vs. urban), and household income. After adjustment for these factors, uninsured children remained significantly more likely than insured children to go without a visit to a physician for pharyngitis (adjusted odds ratio, 1.72; 95 percent confidence interval, 1.11 to 2.68), acute earache (1.85; 95 percent confidence interval, 1.15 to 2.99), recurrent ear infections (2.12; 95 percent confidence interval, 1.28 to 3.51), and asthma (1.72; 95 percent confidence interval, 1.05 to 2.83).
Conclusions:
As compared with children with health insurance, children who lack health insurance are less likely to receive medical care from a physician when it seems reasonably indicated and are therefore at risk for substantial avoidable morbidity.
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