Academic Pediatrics
Volume 16, Issue 2, 2016, Pages 208-215

Trends in Disparities in Low-Income Children's Health Insurance Coverage and Access to Care by Family Immigration Status (Article)

Jarlenski M.* , Baller J. , Borrero S. , Bennett W.L.
  • a Department of Health Policy and Management, University of Pittsburgh Graduate, School of Public Health, 130 DeSoto St, A647, Pittsburgh, PA 15261, United States, Center for Women's Health Research and Innovation, University of Pittsburgh, Pittsburgh, PA, United States
  • b Mathematica Policy Research, Washington, DC, United States
  • c Center for Women's Health Research and Innovation, University of Pittsburgh, Pittsburgh, PA, United States, Division of General Internal Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
  • d Division of General Internal Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, United States, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg, School of Public Health, Baltimore, MD, United States

Abstract

Objective To examine time trends in disparities in low-income children's health insurance coverage and access to care by family immigration status. Methods We used data from the National Survey of Children's Health in 2003 to 2011-2012, including 83,612 children aged 0 to 17 years with family incomes <200% of the federal poverty level. We examined 3 immigration status categories: citizen children with nonimmigrant parents; citizen children with immigrant parents; and immigrant children. We used multivariable regression analyses to obtain adjusted trends in health insurance coverage and access to care. Results All low-income children experienced gains in health insurance coverage and access to care from 2003 to 2011-2012, regardless of family immigration status. Relative to citizen children with nonimmigrant parents, citizen children with immigrant parents had a 5 percentage point greater increase in health insurance coverage (P =.06), a 9 percentage point greater increase in having a personal doctor or nurse (P <.01), and an 11 percentage point greater increase in having no unmet medical need (P <.01). Immigrant children had significantly lower health insurance coverage than other groups. However, the group had a 14 percentage point greater increase in having a personal doctor or nurse (P <.01) and a 26 percentage point greater increase in having no unmet medical need (P <.01) relative to citizen children with nonimmigrant parents. Conclusions Some disparities in access to care related to family immigration status have lessened over time among children in low-income families, although large disparities still exist. Policy efforts are needed to ensure that children of immigrant parents and immigrant children are able to access health insurance and health care. © 2016 Academic Pediatric Association.

Author Keywords

Immigrant Access to care Health insurance disparities

Index Keywords

Parents immigrant nurse lowest income group insurance poverty health insurance human immigration Insurance Coverage statistics and numerical data health status Logistic Models Insurance, Health United States Humans migrant family Adolescent parent Infant, Newborn male Emigrants and Immigrants female preschool child Infant Child, Preschool Multivariate Analysis newborn Article migration physician health care quality health care access Emigration and Immigration statistical model Healthcare Disparities health care disparity Health Services Accessibility health care delivery Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84960797983&doi=10.1016%2fj.acap.2015.07.008&partnerID=40&md5=3b2f1a92f06d567ed5f5b2bb77256b2e
DOI: 10.1016/j.acap.2015.07.008
ISSN: 18762859
Cited by: 7
Original Language: English