Maternal employment and child health

OBJECTIVE: Over 20% of US Children live in households headed by single women; several of these families depend on public health care. Eligibility for public assistance is influenced by the mother's annual income; many working women may earn too much to qualify, but not enough to afford health insurance. We examined 6 predictors of unmet health needs of children of working and non-working single women using data from the National Health Interview Survey (NHIS).

METHODS: Single women with employment data financially supporting 1 or more children < 17 years were sampled from 1997-2008 NHIS (n=18,912). Multivariable logistic-regression analyses assessed the effects of health insurance coverage after adjusting for demographic variables as well as mother's employment and health status.

RESULTS: Approximately 20% of single women with children were unemployed, 74% of their children depended on public insurance coverage. Among employed women, 50% of children were covered by private insurance while 39% used public insurance. Over 10% of children of both employed and unemployed women were without insurance for part of the year. In multivariable models, children demonstrated similar health outcomes for 4 of the 6 predictors regardless of maternal employment status. Unemployed women were significantly less likely to report delayed medical care for their children (OR [95% CI]; 0.68 [0.60-0.76]), as well as unfilled prescriptions (0.81[0.69-0.96]), when compared to their employed counterparts.

CONCLUSIONS: Public insurance coverage may be filling the health care gap for children of unemployed mothers while leaving children of employed mothers uninsured.