206076 Lost Children: An exploration of the Medicaid/SCHIP expansions and child mortality

Tuesday, November 10, 2009: 9:30 AM

Embry M. Howell, MSPH, PhD , Health Policy Center, The Urban Institute, Washington, DC
Sara Hogan, MHS , Health Policy Center, The Urban Institute, Washington, DC
Jonay Foster , Public Health Studies, Johns Hopkins University, Baltimore, MD
Alshadye Yemane, MPP , Health Policy Center, The Urban Institute, Washington, DC
  
Numerous studies have examined the effect of expansions in eligibility for Medicaid and the State Children Health Insurance Program (SCHIP) on program enrollment, access to care, and health outcomes among low-income infants and pregnant women. However, the impacts of eligibility expansions on the health outcomes of children beyond infancy have been explored less. Using the multiple cause of death files from the National Center for Health Statistics, this study examines national trends in childhood mortality and racial disparities in child mortality over 20 years from 1985-2005. We also use mortality data by state, race, and age to explore a possible association between Medicaid/ SCHIP eligibility expansions and child mortality and racial disparities in mortality controlling for year and state effects. For these analyses, data from the March Current Population Survey was used to simulate Medicaid/SCHIP eligibility as the average proportion of a standardized population of children who were eligible for the Medicaid or SCHIP program in each state for each year and age group. We found that expanded Medicaid eligibility is significantly related to the decline in both internal (disease-related) and external (injuries, homicide, and suicide) child mortality during the study period. There was no statistically significant difference between black and white children in this relationship. This study provides encouraging evidence about the effect of expansions in Medicaid and SCHIP eligibility on child health. Future research should continue to try to identify programs or policies that are able to affect the continuing racial disparities in child mortality.

Learning Objectives:
Describe overall trends in national childhood mortality rates over 20 years, 1985-2005 Describe trends in racial disparities in childhood mortality rates over 20 years, 1985-2005 Examine the relationship between Medicaid/SCHIP eligibility expansions and childhood mortality

Keywords: Children, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: throughout my professional experiences and graduate studies, I have performed qualitative and quantitative research on maternal and child health policy issues, and worked extensively on racial/ethnic health disparities and health inequity issues. I participated in a panel at the 2007 APHA Annual Meeting on quality of care and patient-provider communication among primary care providers of color, and co-authored an article published in the October 2006 Journal of the National Medical Association on trends in cardiovascualar diseases among US minority populations. This study was headed by Embry Howell, MSPH, PhD, who has over twenty years of maternal and child health policy research experience, and is built around statistical analyses performed by Alshadye Yemane who has several years experience in statistical programming and data management.
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.

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