The 130th Annual Meeting of APHA

Abstract #47796

Lynn A. Agre, MPH, School of Social Work, Rutgers University, 640 Bartholomew Road - RUTCOR Modular Building, Piscataway, NJ 08854, 732-445-3079, agre@rci.rutgers.edu

The 1987 National Medical Expenditure Survey finding revealed that approximately forty million Americans had no health insurance. A decade later, Congress responded by enacting the 1997 State Children’s Health Insurance Program (SCHIP), expanding health insurance coverage to nearly two-thirds of poor children living below 100% of the Federal poverty level and more than one-quarter of children with incomes between 100% and 199% of the poverty level. While the signing of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act and the Illegal Immigration Reform and Immigrant Responsibility Act underscored the perception that excessive dependency on health and welfare programs could be curtailed, the countervailing SCHIP legislation would buffer the effects of limiting entitlement support to the working poor and their children. Policy makers, however, did not perceive that regardless of citizenship status, those with lower education attainment and income comprised the greatest proportion of those without health insurance. This paper, then, based on data from the 1996 Current Population Survey compares the foreign born versus the native born’s Medicaid and welfare utilization in a series of bivariate graphs, stratified by educational attainment, income and race/ethnicity. These data demonstrate that the sociodemographic characteristics of citizens versus non-citizens, who use Medicaid and welfare services, do not differ. Both groups experience similar barriers in accessing medical care. The recommendation for Federal block grants establishing community medical clinics in targeted areas will be discussed. Partnership with community-based organizations in creating neighborhood health centers would promote delivery of services to underserved populations.

Learning Objectives: At the conclusion of the session, participants will be able to

• Identify disparities in medical care access among socially advantaged and disadvantaged groups stratified by education, income and race/ethnicity.
• Describe the needs of disadvantaged populations in the delivery of medical and social welfare services.
• Develop a hypothetical culturally sensitive community health clinic model, supported through the collaboration of public and private agencies, focusing on the integration of medical and behavioral health interventions.

Keywords: Access and Services, Underserved Populations

Presenting author's disclosure statement:
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.