Health Insurance is a Family Matter (2002) / Chapter Skim
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5 Family Well-Being and Health Insurance Coverage
5 Family Well-Being and Health Insurance Coverage
Pages 90-105
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From page 90... ...
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From page 91... ...
Finding: Extension of publicly supported health insurance to lowincome uninsured parents is associated with increased enrollment among children.
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From page 92... ...
While using different methodologies and different data sets, both studies found that states that had implemented broad coverage expansions to low-income parents had higher child participation rates compared to states that had not expanded coverage to parents (Ku and Broaddus, 2000; Dubay and Kenney, 2002~. One study, based on Current Population Survey (CPS)
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From page 93... ...
Although the process is being simplified in many states, it can still be cumbersome and humiliating (see Box 5.2~. After initial enrollment, public insurance coverage typically lasts for only one year and parents must rece~f:y themselves and their children annually (and sometunes more fFequently3 to maintain coverage.)
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From page 94... ...
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From page 95... ...
used the 1996 - 1997 Community Tracking Study Household Survey to examine the relationship between maternal use of services and children s use and found a strong relationship for a variety of services, including physician visits, emergency department use, hospitalizations and mental health visits. These authors concluded that the strong associations suggest that patterns of maternal use are important for understanding and improving children s health care utilization.
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From page 96... ...
They are more likely than insured adults to rate physician care experiences more negatively and to express dissatisfaction with waiting time and time spent with physicians (Schoen and Puleo, 1998~. Finally, uninsured adults are more likely to have negative experiences with the health care system related to bill paying (Duchon et al., 2001~.
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From page 97... ...
Uninsured adults in poor health are especially likely to encounter access problems in obtaining care for themselves; they are two to three times as likely to go without needed care and are twice as likely to lack a regular source of care as healthier uninsured adults (Schoen and Puleo, 1998; Duchon et al., 2001~. Uninsured adults in fair or poor health are more likely to have experienced a time without needed care than are continuously insured adults of comparable health status.
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From page 98... ...
There is a growing body of evidence that parents mental health strongly affects childrearing practices (Shonkoff and Phillips, 2000~. Those parents reporting poor mental health are more likely to yell and feel frustrated with their children and less likely to read, play with, or hug their children or to establish orderly daily routines for meals, naps, and bedtime (Young et al., 1998)
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From page 99... ...
Daily routines included naps, meals, and bedtime. SOURCE: Young et al., 1998.
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From page 100... ...
showed this association for a group of Medicaid-insured parents. Specifically, parents of children who are in poor physical health or have special health needs are more likely to be in poor mental health themselves than are parents whose children are not in poor physical or mental health.
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From page 101... ...
Only 10 percent of parents in the highest-income group and 17 percent of those from 100 to 200 percent FPL report symptoms of poor mental health compared with 33 percent of those in families with incomes below 100 percent FPL. The physical and mental health of parents serving as the primary child caregiver is related.
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From page 102... ...
describes the possible role of family stress patterns in the development of anorexia nervosa in adolescents, and other studies show an association between family stress and the use of mental health services among children (Verhulst and van der Ende 1997~. It would be reasonable to expect that families with children suffering the ill effects of stress and in need of mental health services would have easier access to them if their children were insured.
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From page 103... ...
For example, parents report that having health insurance for their children reduces the amount of family stress, enables children to get the care they need, and eases family burdens (Lave et al., 1998a)
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From page 104... ...
Recent studies examining the relationship between family stress and health insurance coverage are suggestive and argue for a more systematic assessment of the impact of health insurance on a broad array of indicators of personal and familial well-being. Providing health insurance to all members of a family is one intervention that could improve the health not only of those who gain coverage but also, through the interdependence of the health and activities of family members, of others in the family as well.
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From page 105... ...
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