3209.0: Monday, November 13, 2000 - 5:00 PM

Abstract #13245

Access and Health Care Use in Children of Working Poor Families:Reducing Disparities through Insurance Coverage

Sylvia D. Guendelman, PhD and Michelle M. Pearl, PhD. School of Public Health,Division of Health Policy and Management, University of California, Berkeley, 404 Warren Hall, School of Public Health, Berkeley, CA 94720, 510-642-2848, sylviag@uclink4.berkeley.edu

In our booming economy, many families are working but have a hard time making ends meet, leaving youngsters without health insurance and access to care. This presentation compares health insurance coverage, access to care and physician contacts among 3,148 children in working poor families,661 children in non-working poor families (predominantly welfare) and 4,700 children in moderate-affluent families (affluent).

Using 1996 National Health Interview Survey data, our findings show that compared to children in welfare and affluent families, children in working poor families were more likely to be uninsured and lack a regular care source, and, less likely to have visited a physician in the last year. These differences persisted after controlling for demographic confounders and health status. The adjusted odds ratios for lack of insurance and no regular care source were significantly higher for working poor than welfare children. There were larger disparities when comparing working poor to affluent children.

Children in working poor families face serious barriers to access and utilization. With CHIP and Medicaid expansions, health insurance is finally within their reach. According to our preliminary findings, extending coverage to uninsured children improves the likelihood of access to care and a physician contact. Nevertheless, extending insurance coverage to both the child and the primary caregiver has a stronger effect on children's access and utilization. Policies should consider the advantages of extending coverage to children and their primary caregivers.

Learning Objectives: 1. Identify barriers to access and utilization of health care services among children in working poor families 2. Contrast health care access and utilization for children in working poor families, welfare families and moderate-to-affluent families. 3. Formulate policies that address the health care needs of children in working poor families

Keywords: Access to Health Care, Utilization

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Not applicable
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA