Multivariate Associations Between Child and Family Characteristics and Children’s Access to Health Care (2002–2006)
Demographic and Other Characteristics | Child Coverage Gapa OR (95% CI) | No Usual Source of Care OR (95% CI) | No Doctor Visit in Past 12 Months OR (95% CI) | Child Visits Dentist Less Than 1/yr OR (95% CI) | Any Unmet Health Care NeedbOR (95% CI) |
---|---|---|---|---|---|
Source: 2002–2006 Medical Expenditure Panel Survey (MEPS), Household Component (HC), Agency for Healthcare Research and Quality, Rockville, Maryland. | |||||
CI=confidence interval; FPL = federal poverty level; OR = odds ratio. | |||||
a All children uninsured on December 31 had a coverage gap, so adjusted odds ratio was reported only for the children insured on December 31 who had a coverage gap at some other point during the year. | |||||
b Child had at least 1 of the following 16 unmet needs in the past 12-months: did not get needed care right away, no visits to the doctor’s office, problem in getting needed care, problem in getting specialty care, unable to get needed medical care, problem in not getting needed care, delayed in getting medical care, problem in getting delayed medical care, unable to get needed dental care, problem in not getting needed dental care, delayed in getting dental care, problem in getting delayed dental care, unable to get needed prescription medication, problem in not getting prescription medication, delayed prescription care, problem in delay of getting prescription medication. | |||||
c In 2-parent families, both parents had insurance coverage on December 31 of the given year; in single-parent families, the sole parent had insurance coverage on December 31 of the given year. | |||||
d In 2-parent families, 1 parent had coverage and the other parent did not have insurance coverage on December 31 of the given year. | |||||
e In 2-parent families, both parents did not have insurance coverage on December 31 of the given year; in single-parent families, the sole parent did not have insurance coverage on December 31 of the given year. | |||||
f The household income groups were based on the MEPS-HC constructed variable that divides families into 5 income groups based on earnings as a percentage of the FPL: poor (<100% FPL); near poor (100% to <125% FPL); low income (125% to <200% FPL); middle income (200% to <400% FPL); and high income (>400% FPL). In 2006, the federal poverty level for a family of 4 was $20,000. | |||||
g Child’s race/ethnicity was self-determined by parent respondents based on standard options provided by MEPS interviewers. One combined child race/ethnicity variable was created by combining a race variable—which included white only, black only, American Indian/Alaskan Native only, Asian only, native Hawaiian/Pacific Islander only, and multiple races—and an ethnicity variable—which included Hispanic, or not Hispanic. | |||||
h Family composition refers to whether the child could be linked to 1 parent or 2 parents residing in the same household (it does not account for biological relationship between parent and child or the marriage status between the 2 parents). | |||||
Family insurance patterns | |||||
Child insured, parents insuredc (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Child insured, parents 1 insured, 1 uninsuredd | 2.26 (1.79–2.85) | 1.34 (0.99–1.81) | 1.18 (1.01–1.37) | 1.39 (1.16–1.66) | 1.09 (0.96–1.23) |
Child insured, parents uninsurede | 2.45 (2.02–2.97) | 1.31 (1.10–1.56) | 1.10 (1.00–1.22) | 1.13 (0.97–1.30) | 1.11 (1.01–1.22) |
Child uninsured, parents insuredc | NA | 1.87 (1.46–2.40) | 1.45 (1.16–1.79) | 1.80 (1.39–2.32) | 1.29 (1.05–1.59) |
Child uninsured, parents 1 insured, 1 uninsuredd | NA | 2.89 (2.13–3.92) | 1.68 (1.33–2.14) | 2.83 (2.21–3.61) | 1.49 (1.20–1.84) |
Child uninsured, parents uninsurede | NA | 4.30 (3.65–5.06) | 2.17 (1.94–2.44) | 2.96 (2.55–3.43) | 1.93 (1.73–2.15) |
Household income groupsf | |||||
High income (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Middle income | 2.21 (1.72–2.84) | 1.46 (1.21–1.76) | 1.74 (1.57–1.93) | 1.84 (1.62–2.09) | 1.58 (1.45–1.73) |
Low income | 3.01 (2.32–3.90) | 1.57 (1.27–1.94) | 1.99 (1.74–2.27) | 2.41 (2.06–2.82) | 1.83 (1.65–2.04) |
Near poor | 3.42 (2.47–4.74) | 1.77 (1.38–2.26) | 2.27 (1.94–2.65) | 2.39 (1.95–2.93) | 1.99 (1.74–2.28) |
Poor/negative | 2.62 (1.96–3.50) | 1.60 (1.29–1.99) | 2.20 (1.93–2.51) | 2.35 (1.98–2.78) | 1.96 (1.75–2.20) |
Child’s age, years | |||||
2–4 (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
5–9 | 1.03 (0.90–1.17) | 1.42 (1.24–1.63) | 2.07 (1.85–2.31) | 0.18 (0.16–0.20) | 1.52 (1.40–1.66) |
10–13 | 1.11 (0.94–1.30) | 1.88 (1.61–2.19) | 2.51 (2.24–2.82) | 0.17 (0.15–0.19) | 1.69 (1.54–1.85) |
14–17 | 1.06 (0.91–1.24) | 2.85 (2.40–3.38) | 2.87 (2.55–3.22) | 0.27 (0.24–0.31) | 2.00 (1.82–2.20) |
Child’s race/ethnicityg | |||||
White, non-Hispanic (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Hispanic, any race | 1.32 (1.10–1.59) | 1.73 (1.43–2.10) | 1.37 (1.23–1.53) | 1.11 (0.97–1.26) | 1.10 (1.00–1.20) |
Nonwhite, non-Hispanic | 0.95 (0.78–1.15) | 1.59 (1.32–1.93) | 1.48 (1.33–1.64) | 1.06 (0.95–1.18) | 1.14 (1.05–1.24) |
Family compositionh | |||||
2 parents in household (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
1 parent in household | 1.23 (1.05–1.44) | 1.09 (0.93–1.27) | 0.95 (0.88–1.03) | 1.16 (1.03–1.26) | 1.06 (0.98–1.14) |
At least 1 parent completed high school | |||||
Yes (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
No | 1.07 (0.91–1.26) | 1.40 (1.23–1.60) | 1.39 (1.26–1.54) | 1.42 (1.25–1.60) | 1.17 (1.06–1.29) |
At least 1 parent employed | |||||
Not currently employed (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Employed/self-employed | 0.83 (0.68–1.02) | 0.86 (0.73–1.01) | 1.26 (1.12–1.42) | 1.04 (0.89–1.22) | 1.12 (1.02–1.24) |
Geographic residence | |||||
Northeast (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
West | 1.46 (1.13–1.88) | 2.93 (2.19–3.91) | 2.29 (1.92–2.72) | 1.39 (1.17–1.66) | 1.97 (1.73–2.25) |
South | 1.44 (1.13–1.83) | 2.89 (2.22–3.77) | 1.70 (1.44–2.01) | 1.42 (1.22–1.66) | 1.58 (1.40–1.78) |
Midwest | 1.16 (0.90–1.49) | 1.93 (1.43–2.61) | 1.69 (1.41–2.03) | 1.24 (1.04–1.48) | 1.46 (1.28–1.67) |
Child health status | |||||
Excellent (reference group) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Not excellent | 0.99 (0.89–1.11) | 0.93 (0.83–1.04) | 0.71 (0.66–0.76) | 1.19 (1.10–1.29) | 1.10 (1.04–1.17) |