Magnitude and Determinants of Uninsured Children in the US: A Study of the 2005-2006 NHANES

Prevalence of lack of health insurance in US children (0 to 17 years of age) and associated factors were investigated using the 2005-2006 National Health and Nutrition Examination Survey (NHANES). A total of 7.6 million or 11% of US children were uninsured, although 68% of uninsured were eligible. Both questions about citizenship of the children and place of birth of the parents were asked inthe 2005-2006 NHANES. This study assessed the role of citizenship status of the child and place of birth of the parents on uninsured children. Other factors such as ethnicity/race, poverty level, and parental education were considered in relation to the child's health insurance status. Using weighted stratified and logistic regression analysis, we found the following unadjusted effects: citizenship status of the child (OR=18), parents born in Mexico (OR=7), Mexican-American Ethnicity (OR=5), and Spanish spoken at home (OR=6). In multivariate analysis, citizenship and education were the significant correlates such that children who were not US citizens or naturalized residents and those whose parents had up to 12 years of education, were more likely to be uninsured with significant ORs of 8 and 2, respectively. Language, age, ethnicity/race and nativity of parents were not statistically associated with lack of health insurance in US children. Low socioeconomic status as measured by education is associated with 42% of uninsured children in the US, and immigration and not US citizenship of the child with only 10% and 6% of the cases, respectively.