Reducing health disparities among children

Future of Children

Volumn 13, Issue 1, 2003, Pages 153-167

  Hughes, Dana C ^a   Ng, Sandy ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CHILD HEALTH; CULTURAL ANTHROPOLOGY; EDUCATION; EMOTIONAL STRESS; FINANCIAL MANAGEMENT; GEOGRAPHY; HEALTH CARE ACCESS; HEALTH STATUS; HUMAN; LANGUAGE; LOWEST INCOME GROUP; MEDICAL RESEARCH; MOTIVATION; PARENT; PUBLIC HEALTH INSURANCE; RACE; REVIEW; ARTICLE; CHILD; CHILD HEALTH CARE; CHILD WELFARE; ECONOMICS; HEALTH CARE POLICY; HEALTH INSURANCE; ORGANIZATION AND MANAGEMENT; SOCIOECONOMICS; STANDARD; STATISTICS; UNITED STATES;

CHILD; CHILD HEALTH SERVICES; CHILD WELFARE; ELIGIBILITY DETERMINATION; HEALTH POLICY; HUMANS; INSURANCE, HEALTH; SOCIOECONOMIC FACTORS; UNITED STATES;

EID: 0242335972     PISSN: 10548289     EISSN: 15501558     Source Type: Journal    
DOI: 10.2307/1602645     Document Type: Review

References (100)

1. Starfield, B. Child health care and social factors: Poverty, class, race. Bulletin of the New York Academy of Medicine (1989) 65(3):299-306.
2. Syme, S.L., and Berkman, L.F. Social class, susceptibility and sickness. American Journal of Epidemiology (1976) 104(1):1-8.
3. Starfield, B. Social, economic, and medical care determinants of children's health. In Health care for children: What's right, what's wrong, what's next. R. Stein, ed. New York: United Hospital Fund, 1997.
4. For example, Kaiser Permanente in California created the Child Health Plan, a subsidized product for selected low-income, uninsured children who are not eligible for Medicaid or SCHIP. See http://www.kff.org/content/2001/3037.
5. Starfield, B., and Budetti, P.P. Child health status and risk factors. Health Services Research (1985) 19(6, Pt 2):817-86.
6. Urban Institute. Unpublished data. January 2002.
7. Wise, P.H., Kotelchuck, M., Wilson, M.L., and Mills, M. Racial and socioeconomic disparities in childhood mortality in Boston. New England Journal of Medicine (1985) 313(6):360-406.
8. See note 3, Starfield.
9. McCarty, D., and Levine, H.J. Needs of people with chronic and disabling conditions. In Access to health care: Promises and prospects for low-income Americans. M. Lillie-Blanton, R. Martinez, B. Lyons, and D. Rowland, eds. Washington, DC: Kaiser Commission on Medicaid and the Uninsured, 1999.
10. Newacheck, P.W. Poverty and childhood chronic illness. Archives of Pediatrics and Adolescent Medicine (1994) 148(11):1143-49.
11. Newacheck, P.W., and Starfield, B. Morbidity and use of ambulatory care services among poor and nonpoor children. American Journal of Public Health (1988) 78(8):927-33.
12. Newacheck, P., Jameson, W.J., and Halfon, N. Health status and income: The impact of poverty on child health. Journal of School Health (1994) L64(6):229-33.
13. Adler, N.E., Boyce, W.T., Chesney, M.A., et al. Socioeconomic inequities in health: No easy solution. Journal of the American Medical Association (1993) 269(24):3140-45.
14. Haan, M.N., Kaplan, G.A., and Syme, S.L. Socioeconomic status and health: Old observations and new thoughts. In Pathways to health. Menlo Park, CA: Kaiser Family Foundation, 1987.
15. Susser, M., Watson, W., and Hopper, K. Social class and disorders in health. In Sociology in medicine. New York: Oxford University Press, 1985.
16. See, for example, Lieu, T.A., Newacheck, P.W., and McManus, M.A. Race, ethnicity, and access to ambulatory care among U.S. adolescents. American Journal of Public Health (1993) 83(7):960-65;
17. Newacheck, P.W., Hughes, D.C., and Stoddard, J. Children's access to primary care: Differences by race, income, and insurance status. Pediatrics (1996) 97(1):26-32;
18. Cornelius, L.J. Barriers to medical care for white, black, and Hispanic American children. Journal of the National Medical Association (1993) 85(4):281-88;
19. and Flores, G., Bauchner, H., Feinstein, A.R., and Nguyen, U.S. The impact of ethnicity, family income, and parental education on children's health and use of health services. American Journal of Public Health (1999) 89(7):1066-71.
20. Weech-Maldonado, R., Morales, L., Spritzer, K., et al. Racial and ethnic differences in parents' assessments of pediatric care in Medicaid managed care. Health Services Research (2001) 36(3):575-94.
21. Evans, R.G., and Stoddard, G.L. Producing health, consuming health care. Social Science Medicine (1990) 31(12):1347-63. See also note 5, Starfield and Budetti.
22. National Center for Health Statistics. Healthy People 2000. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/nchs/about/otheract/ hp2000/ hp2000.htm. Accessed on June 10, 2002.
23. National Center for Health Statistics. About Healthy People 2010. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/nchs/ about/otheract/ hpdata2010/abouthp.htm. Accessed on June 26, 2002.
24. Newacheck, P.W., Stoddard, J.J., Hughes, D.C., and Pearl, M. Health insurance and access to primary care for children. New England Journal of Medicine (1998) 338(88):513-19.
25. Newacheck, P.W., Hughes, D.C., Hung, Y.Y., et al. The unmet health needs of America's children. Pediatrics (2000) 105(1, Pt 3):989-97.
26. Dubay, L., and Kenney, G.M. Health care access and use among low-income children: Who fares best? Health Affairs (2001) 20(1):112-21.
27. See note 21, Newacheck, et al.
28. McCormick, M.C., Kass, B., Elixhauser, A., et al. Annual report on access to and utilization of health care for children and youth in the United States-1999. Pediatrics (2000) 105(1):219-30.
29. Kaestner, R., Joyce, T., and Racine, A. Medicaid eligibility and the incidence of ambulatory care sensitive hospitalizations for children. Social Science & Medicine (2001) 52(2):305-13.
30. It is important to note that some of these studies are unable to control for reasons for seeking health insurance programs, thereby potentially introducing bias in the findings if certain individuals who want insurance for their children are more likely to enroll precisely because they have a greater need for health services (thereby "artificially" increasing demand for care).
31. Lave, J., Keane, C.R., Lin, C.J., et al. Impact of a children's health insurance program on newly enrolled children. Journal of the American Medical Association (1998) 279(22):1820-25. See also note 21, Newacheck, et al.; note 25, McCormick, et al.; and note 26, Kaestner, et al. It is important to note that some of these studies are unable to control for reasons for seeking health insurance programs, thereby potentially introducing bias in the findings if certain individuals who want insurance for their children are more likely to enroll precisely because they have a greater need for health services (thereby "artificially" increasing demand for care).
32. Holl, J.L., Szilagyi, P.G., Rodewald, L.E., et al. Evaluation of New York State's Child Health Plus: Access, utilization, quality of health care, and health status. Pediatrics (2000) 105(3, Suppl E):711-18.
33. See note 21, Newacheck, et al.
34. See note 23, Dubay and Kenney.
35. One reason larger access effects have not been observed following recent eligibility expansions may be that some children who enrolled were either served by the safety net previously or had private coverage.
36. See note 28, Lave, et al.
37. Currie, J., and Gruber, J. Health insurance eligibility, utilization of medical care and child health. Quarterly Journal of Economics (1996) 111(2):431-66.
38. Racine, A.D., Kaestner, R., Joyce, T.J., and Coleman, G.J. Differential impact of recent Medicaid expansions by race and ethnicity. Pediatrics (2001) 108(5):1135-42.
39. See note 23, Dubay and Kenney.
40. Short, P.F., and Lefkowitz, D.C. Encouraging preventive services for low-income children: The effect of expanding Medicaid. Medical Care (1992) 30(9):766-80.
41. Currie, J., and Thomas, D. Medical care for children: Public insurance, private insurance and racial differences in utilization. Journal of Human Resources (1995) 30(1):135-63.
42. Halfon, N., Inkelas, M., and Wood, D. Nonfinancial barriers to care for children and youth. Annual Review of Public Health (1995) 16:447-72.
43. Keane, C.R., Lave, J.R., Ricci, E.M., and LaVallee, C.P. The impact of a children's health insurance program by age. Pediatrics (1999) 104(5, Pt 1):1051-58.
44. See note 28, Lave, et al.
45. Riley, T., Pernice, C., Perry, M., and Kannel, S. Why eligible children lose or leave SCHIP. Portland, ME: National Academy for State Health Policy, February 2002.
46. See note 35, Racine, et al.
47. See note 34, Currie and Gruber.
48. See note 26, Kaestner, et al.
49. See note 29, Holl, et al.
50. Szilagyi, P.G., Holl, J.L., Rodewald, L.E., et al. Evaluation of New York State's Child Health Plus: Children who have asthma. Pediatrics (2000) 105(3, Suppl E):719-27.
51. Valdez, R.B., Brook, R.H., Rogers, W.H., et al. Consequences of cost-sharing for children's health. Pediatrics (1985) 75(5):952-61.
52. The findings from this study have been called into question for what critics consider methodological flaws. See Starfield, B., and Dutton, D. Care, costs and health: Reactions to and reinterpretation of the Rand findings. Pediatrics (1985) 76(4):614-21; and
53. Haggerty, R.J. The Rand Health Insurance Experiment for children. Pediatrics (1985) 75(5):969-71.
54. Bergner, M., and Rothman, M.L. Health status measures: An overview and guide for selection. Annual Review of Public Health (1987) 8:191-210.
55. See note 34, Currie and Gruber.
56. Centers for Disease Control. America's children: Key national indicators of well-being 2001. Washington, DC: U.S. Government Printing Office, 2001.
57. See note 26, Kaestner, et al.
58. Kenney, G., and Haley, J. Why aren't more uninsured children enrolled in Medicaid or SCHIP? Assessing the New Federalism Policy Brief No. B-35. Washington, DC: Urban Institute, May 2001. See also the article by Holahan, Dubay, and Kenney in this journal issue.
59. Perry, M., Kannel, S., Valdez, R.B., and Chang, C. Medicaid and children: Overcoming barriers to enrollment - findings from a national survey. Menlo Park, CA: The Henry J. Kaiser Family Foundation, 2000.
60. Ellwood, M. The Medicaid eligibility maze: Coverage expands, but enrollment problems persist: Findings from a five state study. Cambridge, MA: Mathematica Policy Research, 1999.
61. Kenney, G., Haley, J., and Dubay, L. How familiar are lowincome parents with Medicaid and SCHIP? Washington, DC: Urban Institute, 2001.
62. Starfield, B. Effects of poverty on health status. Bulletin of the New York Academy of Medicine (1992) 68(1):17-24.
63. See note 5, Starfield and Budetti.
64. Newacheck, P.W. Access to ambulatory care for poor persons. Health Services Research (1988) 23(3):401-19.
65. Klerman, L. Alive and well? A research and policy review of health programs for poor young children. New York: National Center for Children in Poverty, Columbia University, 1991.
66. Wilhelmsen, L. Coronary heart disease: Epidemiology of smoking and intervention studies of smoking. American Heart Journal (1988) 115(1, Pt 2):242-49.
67. Otten, M.W., Teutsch, S.M., Williamson, D.F., and Marks, J.S. The effect of known risk factors on the excess mortality of black adults in the United States. Journal of the American Medical Association (1990) 263(6):845-50.
68. Paffenbarger, R.S., Hyde, R.T., Wing, A.L., et al. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. New England Journal of Medicine (1993) 328(8):538-45.
69. Case, A., and Paxson, C. Parental behavior and child health: Health coverage by itself may not influence some of the healthrelated behavior that affects children's health. Health Affairs (2002) 21(2):164-78.
70. See note 39, Halfon, et al.
71. St. Peter, R.F., Newacheck, P.W., and Halfon, N. Access to care for poor children: Separate and unequal? Journal of the American Medical Association (1992) 267(20):2760-64.
72. Committee on Overcoming Barriers to Immunization, Division of Health Promotion and Disease Prevention. Overcoming barriers to immunization: A workshop summary. Washington, DC: Institute of Medicine, 1994.
73. Riportella-Muller, R., Selby-Harrington, M.L., Richardson, L.A., et al. Barriers to use of preventive health care services for children. Public Health Reports (1996) 111(1):71-77.
74. Uba, L. Cultural barriers to health care for Southeast Asian refugees. Public Health Reports (1992) 107(5):544-48.
75. See note 13, Adler, et al.
76. Kaplan, G.A., Haan, N.M., Syme, S.L., et al. Socioeconomic status and health. In Closing the gap: The burden of unnecessary illness. R.W. Amer and H.B. Dull, eds. New York: Oxford University Press, 1987.
77. Derose, K.P., and Baker, D.W. Limited English proficiency and Latinos' use of physician services. Medical Care Research and Review (2000) 57(1):76-91.
78. Weinick, R.M., and Krauss, N.A. Racial/ethnic differences in children's access to care. American Journal of Public Health (2000) 90(11):1771-74.
79. Hughes, D., Cart, C., Vogel, S., et al. Barriers to enrollment in Healthy Families and Medi-Cal: Findings from nine focus groups with Chinese, Korean, and Vietnamese parents of eligible children. San Francisco: Institute for Health Policy Studies, University of California, San Francisco, 2000.
80. See note 70, Uba.
81. See note 55, Perry, et al.
82. See note 75, Hughes, et al.
83. Hughes, D., Cart, C., Moreno, M., and Ng, S. Barriers to enrollment in Healthy Families and Medi-Cal: Differences by race and ethnicity. San Francisco: Institute for Health Policy Studies, University of California, San Francisco, 2000.
84. Dutton, D.B. Financial, organizational, and professional factors affecting health care utilization. Social Science and Medicine (1986) 23:721-35.
85. See note 39, Halfon, et al.
86. Yudkowsky, B.K., Tang, S.F., and Siston, A.M. Pediatrician participation in Medicaid/SCHIP: Survey of fellows of the American Academy of Pediatrics, 2000. Elk Grove Village, IL: American Academy of Pediatrics, 2001. Available online at http://www.aap.org/statelegislation/med-schip/ped_part.htm.
87. Cohen, J.W., and Cunningham, P.J. Medicaid physician fee levels and children's access to care. Health Affairs (1995) 14(1):255-62.
88. See note 23, Dubay and Kenney.
89. The extent to which regular sources of care are primary care providers is usually explored in research because both primary care providers and specialists practice in ambulatory care settings, and it can be difficult to discern if a regular source of care is a primary care provider.
90. Starfield, B. Evaluating the State Children's Health Insurance Program: Critical considerations. Annual Review of Public Health (2000) 21:569-85.
91. Starfield, B. Primary care and health: A cross-national comparison. Journal of the American Medical Association (1991) 266(16):2268-71.
92. See note 37, Short and Lefkowitz.
93. Kasper, J.D. The importance of type of usual source of care for children's physician access and expenditures. Medical Care (1987) 25(5):386-98.
94. Becker, M.H., and Maiman, L.A. Sociobehavioral determinants of compliance with health and medical care recommendations. Medical Care (1975):13(1):10-24.
95. See note 87, Starfield.
96. Starfield, B., and Shi, L. Policy relevant determinants of health: An international perspective. Health Policy (2002) 60(3):201-18.
97. The specific characteristics studied include health system characteristics related to regulation, financing, access arrangements, and the strength of primary care and general practice academic departments, as well as practice characteristics related to first-contact care, contact over time with a usual source of care, comprehensiveness, coordination, family-centeredness, and community orientation.
98. See note 92, Starfield and Shi.
99. See note 13, Adler, et al.
100. Wilkinson, R.G. Income distribution and life expectancy. British Journal of Medicine (1992) 304(6820):165-68.