178883 Magnitude and Determinants of Uninsured Children in the US: A Study of the 2005-2006 NHANES

Sunday, October 26, 2008

Victor Cardenas, MD, MPH, PhD , Epidemiology/El Paso Regional Campus, University of Texas HSC at Houston School of Public Health, El Paso, TX
Patrick M. Tarwater, PhD , Biostatistics/El Paso Regional Campus, UT HSC at Houston School of Public Health, El Paso, TX
Melchor Ortiz, PhD , El Paso, Regional Campus, UT Health Science Center-School of Public Health, EL Paso, TX
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.

Learning Objectives:
Participants will learn about the magnitude of the problem of uninsured children in the US, and the disparities by socioeconomic and other correlates such as immigration which are erroneously assigned a larger role in the media than they actually have Participants will also learn about how at the national level, using the largest health survey available, NHANES, that asked for the first time about citizenship of the children and the place of birth of their parents, the increased proportions of uninsured children among the category of Mexican Americans indeed only reflects other disadvantages in life. Participants will learn too that across the board most of the uninsured children in the US owed their status to being poor, as measured by parental education, and very little of the problem can be attributed to immigration.

Keywords: Access to Health Care, Child/Adolescent

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Planned, designed, analyzed and wrote the paper
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.