The 130th Annual Meeting of APHA

Abstract #48821

Pamela R. Wood, MD¹, Lauren A. Smith, MD, MPH², Diana Romero, PhD, MA³, Wendy Chavkin, MD, MPH³, and Paul Wise, MD, MPH². (1) Department of Pediatrics, University of Texas Health Science Center, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, 210-562-5344, woodp@uthscsa.edu, (2) Boston Medical Center, Maternity 4, Dept of Pediatrics, One Boston Medical Center Place, Boston, MA 02118, (3) Department of Population and Family Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032

Objective: Evaluate the effect of health insurance status and welfare status on the health of children with asthma. Methods: Cross sectional interview study of 386 caretakers of children with asthma, age 2-12 years, presenting to urban clinical sites and welfare offices. Data were collected on asthma symptoms (Rosier scale), health care utilization (HCU), health insurance status, welfare status [current (CR), N=53; former (FR), N=95; applied/denied (A/D), N=34; applied/pending (A/P), N=36; non-recipients (NR), N=168], and other demographic variables. Multivariate analyses examined the effect of welfare status, health insurance status, and demographic variables on outcomes. Results: Children of respondents who had never applied for welfare had lower symptom scores than those who had some contact with the welfare system [NR (9.3), A/D (13.2), A/P (12.6), (p=.01)] and were less likely to have experienced a severe episode (p=.03). Children of CR had the highest number of school days missed (p=.01). Neither health insurance status nor welfare status was associated with health care utilization (HCU); income was negatively associated with HCU. Children who were always insured experienced fewer barriers to health care than those who were never or transiently insured, (p<.0001); race and income were also associated with barriers (p=.03; p<.01). Conclusions: Welfare status is independently associated with asthma symptoms; insurance status and other demographic variables are independently associated with barriers to health care. Children of families who have contact with the welfare system and transiently insured/ uninsured children are at high-risk medically and may require additional services to improve asthma health outcomes.

Learning Objectives:

• Describe the association between welfare status and asthma symptoms in children.
• Describe the impact of insurance status and sociodemographic factors on access to health care.
• Recognize that children of families who have contact with the welfare system are at high-risk medically.

Keywords: Health Insurance, Welfare

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.