 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Emily Feinberg, Sc D1, Rebecca E. Goldstein, ScM2, and Kayla Raynor, MPH2. (1) Department of Maternal and Child Health, Boston University School of Public Health, Talbot Building - 5W, 715 Albany St, Boston, MA 02118, 617-414-3667, emily.feinberg@bmc.org, (2) Bureau of Family and Community Health, Massachusetts Department of Public Health, 250 Washington Street, 5th floor, Boston, MA 02108
SCHIP expanded health insurance to large numbers of adolescents who previously were not eligible for coverage under Medicaid. Thirteen state SCHIPs cover children up to age 19 with incomes > 200% FPL. As higher-income adolescents who have not previously had access to public health insurance enroll in programs, it is important to examine their participation and health needs. We examined differences in demographics, health status, need for services, and unmet need/delayed care between higher-income adolescents (ages 12-19) and younger children (ages 0-11) who enrolled in a public health insurance program. Massachusetts has provided insurance coverage to children with incomes > 200% FPL under a separate state-funded program since 1996. We conducted a telephone survey of a random sample of 750 of the 4100 children and adolescents who enrolled in the program between 8/15 and 11/15/2000. Parents were interviewed 6 and 12 months after the child’s enrollment to obtain information about insurance characteristics, need for services, and unmet health need. Adolescents (ages 12-19) represented 26% of program enrollees. Compared to younger children, they were significantly more likely to have been uninsured for > than 6 months prior to enrollment (30% vs. 21%), report compromised health (22% vs.14%), have had previous employment-based insurance (48% vs. 38%), and have parents who were not working full time at the time of enrollment (52% vs. 36%). They did not differ from younger enrollees with respect to family income, ethnicity, parental education and marital status. Adolescents had greater need for primary care and ancillary services (mental health, dental, and vision) before enrollment and greater difficulty obtaining needed services. Once enrolled, adolescents did not differ from children in their length of enrollment, health status, and unmet health need. They did, however, need more services. 57% of adolescents as compared to 36% of children needed three or more different types of services while enrolled. Findings suggest that higher-income adolescents used the program to fill gaps in employment-based insurance during parental job transitions. Compared to younger children, they represent a higher risk group in terms of health status and need for services. Receipt of health insurance eliminated disparities in reported health status and unmet health need between adolescents and younger children.
Learning Objectives:
Keywords: Adolescent Health, Health Insurance
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.