 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jean C. Willard, MPH and Peter C. Damiano, DDS, MPH. Public Policy Center, University of Iowa, 227 South Quadrangle, Iowa City, IA 52242, (319)335-6800, jean-willard@uiowa.edu
Study Design: Interviewers administered a 15-minute telephone-based questionnaire to the parent of a randomly selected child in each of approximately 3200 households in Iowa selected using a random digit dial method. The questionnaire included approximately 125 questions concerning functional health status; health care; insurance; school and social factors; childcare; and demographic information. Data were weighted and post-stratified to provide population-based results for all children living in families in Iowa. Bivariate analyses evaluated relationships to being 1)uninsured, 2)covered by Medicaid, or 3) privately insured. Factors included health status, health insurance, access to care, social factors, and demographics. Chi-square tests were conducted (differences considered significant at p<.05). Principal Findings: Uninsured children were more likely to be rated in excellent overall health (70.8% vs. 50.3% Medicaid, 67.9% private ) and less likely to have a special health care need (10% vs. 32.8% Medicaid, 15.9% private). Utilization was lower for uninsured (17.9% had zero visits vs. 7.7% Medicaid, 8.0% private) however unmet need for medical care was higher (8% uninsured, 3.3% Medicaid, 2.3% private). Parents of uninsured children worried more about paying for their child’s health care (51.2% worried a great deal vs. 15.6% Medicaid, 5.4% private). Parents rated Medicaid coverage as excellent more often than did those with privately insured children (44.3% vs. 29.7%). Medicaid-enrolled children were more likely to have been uninsured at some point in the past year (22.4% Medicaid vs. 4.2% private). School-age privately insured children were least likely to have low-engagement in school (4 item scale) (21.0% uninsured, 25.7% Medicaid, 12.8% private). Medicaid enrolled children were least likely to have high-engagement (43.0% uninsured, 31.0% Medicaid, 41.1% private). Uninsured children ages 0-9 were most likely to be in child care settings for 40 or more hours per week (25% vs 11% Medicaid, 16% privately insured). Conclusions: Uninsured children were more likely than Medicaid enrolled or privately insured children to have problems accessing health care. Uninsured children were reported to have higher health status and lower utilization howeve r their parents worried more about health care costs. Young uninsured children spend were more likely to spend 40 or more hours in childcare. Although parents rated Medicaid coverage higher, children in Medicaid were more likely to lose their coverage at some point in time.
Learning Objectives:
Keywords: Child Health, Insurance
Related Web page: ppc.uiowa.edu/iowachild2000
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.