 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Sabrina T. Wong, RN, PhD, Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, Box 0856, 3333 California Street, Suite 335, San Francisco, CA 94143, 415-514-3355, sabrina@itsa.ucsf.edu, Paul Newacheck, DrPH, Institute for Health Policy Studies, University of California, San Francisco, 3333 California St., Suite 265, San Francisco, CA 94118, Alison A. Galbraith, MD, Robert Wood Johnson Clinical Scholars Program, University of Washington, Box 357183, Seattle, WA 98195-7183, and Dean Sonneborn, MSW, Institute for Health Policy Studies, University of California at San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143-0936.
Significance. Prompted by a series of federal initiatives, the health services research community is focused on identifying and documenting disparities in health and health care among racial/ethnic groups as well as across income distributions. However, little work has addressed disparities of the economic burden of illness. Specific Aims. The specific aim of this study was to examine the extent to which economic disparities exist in out-of-pocket health care expenditures for children and the role that heath insurance plays in reducing or eliminating these disparities. We examined whether disparities existed in out-of-pocket expenditures among children with different incomes and among children from different racial/ethnic backgrounds (African American, Latino, White). Methods. Using the 1998-99 Medical Expenditure Panel Survey (MEPS), we used multivariate regression to examine children’s financial burden. Financial burden was expressed as two dependent variables, a) the ratio of annual out-of-pocket health care expenses to annual family income and b) whether out-of-pocket health care expenses reach certain catastrophic thresholds (e.g. 5% of family income). Results. After controlling for child’s age and sex, parent’s educational status (< high school, high school, some college, college graduate), family size (<5, >5), family structure (one parent, two or more parents), region, residence, health status, limitation of activity, insurance status (full year coverage, partial year, and uninsured), and family income (expressed in poverty thresholds), children in poorer families (<100% and 100%-199% FPL-federal poverty level) experienced substantially greater financial burden. African American children were substantially better protected from out-of-pocket health care expenses compared to White children. Discussion. Given the extensive data that minority adults and children face disparities in health status and health care, it is surprising that we found what appears to be a protective effect for African American children. There are several possible interpretations of this finding which merit further study.
Learning Objectives:
Keywords: Health Insurance, Children and Adolescents
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.