The Health Status of U.S. Hispanic Children

2019 ◽  
pp. 97-115
Author(s):  
Fernando S. Mendoza ◽  
Stephanie J. Ventura ◽  
Laura Saldivar ◽  
Katherine Baisden ◽  
Reynaldo Martorell
Keyword(s):  
Health Status ◽  
Hispanic Children

The Role of Race and Ethnicity in the State Children’s Health Insurance Program (SCHIP) in Four States: Are There Baseline Disparities, and What Do They Mean for SCHIP?

PEDIATRICS ◽  
2003 ◽  
Vol 112 (Supplement_E1) ◽  
pp. e521-e532
Author(s):  
Laura P. Shone ◽  
Andrew W. Dick ◽  
Cindy Brach ◽  
Kim S. Kimminau ◽  
Barbara J. LaClair ◽  
...  
Keyword(s):  
Health Care ◽  
New York ◽  
Health Insurance ◽  
Health Status ◽  
Race And Ethnicity ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Hispanic Children ◽  
White Children

Background. Elimination of racial and ethnic disparities in health has become a major national goal. The State Children’s Health Insurance Program (SCHIP) has the potential to reduce disparities among the children who enroll if they exhibit the same disparities that have been documented in previous studies of low-income children. To determine the potential impact of SCHIP on racial and ethnic disparities, it is critical to assess baseline levels of health disparities among children enrolling in SCHIP. Objective. To use data from the Child Health Insurance Research Initiative (CHIRI) to 1) describe the sociodemographic profile of new enrollees in SCHIP in Alabama, Florida, Kansas, and New York; 2) determine if there were differences in health insurance and health care experiences among white, black, and Hispanic SCHIP enrollees before enrollment in SCHIP; and 3) explore whether race or ethnicity, controlled for other factors, affected pre-SCHIP access to health coverage and health care. Setting. SCHIP programs in Alabama, Florida, Kansas, and New York, which together include 26% of SCHIP enrollees nationwide. Design. Telephone interview (mailed survey in Alabama) about the child’s health, health insurance, and health care experiences conducted shortly after SCHIP enrollment to assess experience during the time period before SCHIP. Sample. New SCHIP enrollees (0–17.9 years old in Alabama, Kansas, and New York and 11.5–17.9 years old in Florida). Stratified sampling was performed in Kansas and New York, with results weighted to reflect statewide populations of new SCHIP enrollees. Measures. Sociodemographic characteristics including income, education, employment, and other characteristics of the child and the family, race and ethnicity (white non-Hispanic, black non-Hispanic, and Hispanic [any race]), prior health insurance, health care access and utilization, and health status. Analyses. Bivariate analyses were used to compare baseline measures upon enrollment for white, black, and Hispanic SCHIP enrollees. Multivariate analyses were performed to assess health status and health care access measures (prior insurance, presence of a usual source of care (USC), and use of preventive care), controlling for demographic factors described above. Weighted analyses (where appropriate) were performed by using SPSS, STATA, or SUDAAN. Results. Racial and ethnic composition varied across the SCHIP cohorts studied, with black and Hispanic children comprising the following proportion of enrollees, respectively: Alabama, 33% and <1%; Florida, 16% and 26%; Kansas, 12% and 15%; and New York, 24% and 36%. Black and Hispanic children were more likely to reside in single-parent and lower-income families. With some variation by state, children from minority groups were more likely to report poorer health status than were white children. Relative to white children, children from minority groups in Florida and New York were more likely to have been uninsured for the entire year before SCHIP enrollment. In all states, children from minority groups who had prior coverage were more likely to have previously been enrolled in Medicaid than in private health insurance and were less likely to have had employer-sponsored coverage compared with white children. Except in Alabama, there was a difference in having a USC, with children from minority groups less likely to have had a USC before SCHIP enrollment compared with white children. No consistent pattern of health care utilization before SCHIP was noted across states with respect to race or ethnicity. Findings from multivariate analyses, controlling for sociodemographic factors, generally confirmed that black and Hispanic children were more likely to have lacked insurance or a USC before enrollment in SCHIP and to have poorer health status compared with white children. Conclusions. SCHIP is enrolling substantial numbers of racial and ethnic minority children. There are baseline racial and ethnic disparities among new enrollees in SCHIP, with black and Hispanic children faring worse than white children on many sociodemographic and health system measures, and there are differences among states in the prevalence and magnitude of these disparities. After controlling for sociodemographic factors, these disparities persisted. Implications for Monitoring and Improving SCHIP. SCHIP has the potential to play a critical role in efforts to eliminate racial and ethnic disparities in health among the children it serves. However, study findings indicate that programmatic efforts are necessary to ensure that disparities are not perpetuated. Program effectiveness and outcomes should be monitored by race and ethnicity to ensure equity in access, use, and outcomes across all racial and ethnic groups. Assessing the health characteristics and needs of new SCHIP enrollees can provide a benchmark for evaluating the program’s impact on eliminating racial and ethnic disparities in health and inform service delivery enhancements.

The Health Status of U.S. Hispanic Children

2019 ◽  
pp. 97-115
Author(s):  
Fernando S. Mendoza ◽  
Stephanie J. Ventura ◽  
Laura Saldivar ◽  
Katherine Baisden ◽  
Reynaldo Martorell
Keyword(s):  
Health Status ◽  
Hispanic Children

scholarly journals Maternal Educational Attainment and Child Health in the United States

2019 ◽  
Vol 34 (3) ◽  
pp. 303-306 ◽  
Author(s):  
Elizabeth M. Lawrence ◽  
Richard G. Rogers ◽  
Robert A. Hummer
Keyword(s):  
United States ◽  
Health Status ◽  
Child Health ◽  
Educational Attainment ◽  
Maternal Education ◽  
Mexican Origin ◽  
Hispanic Children ◽  
Child Health Status ◽  
Race Ethnicity ◽  
And Child Health

Purpose: To identify how child health status differs by mother’s educational attainment for the overall US population and by race/ethnicity and to assess whether these disparities have changed from 2000 to 2017. Design: Repeated cross-sectional data from the 2000-2017 National Health Interview Survey (NHIS). Setting: United States. Participants: Children aged 1 to 17 years from a nationally representative sample of the noninstitutionalized US population (N = 199 427). Measures: Reported child health status, mother’s educational attainment, child’s race/ethnicity, and control variables were measured using the NHIS. Analysis: Using logistic regression models, we assessed the relationship between maternal education and child health. Missing data were imputed. Results: Children whose mothers had less than a high school education (odds ratio [OR] = 3.84, 95% confidence interval [CI]: 3.62-4.07), high school diploma or equivalent (OR = 2.57, 95% CI: 2.44-2.70), or some college (OR = 1.90, 95% CI: 1.80-2.00) had worse reported health status compared to children whose mothers graduated college. These associations were strongest among non-Hispanic white children, with significantly ( P < .05) smaller associations observed for non-Hispanic black, Mexican origin, and other Hispanic children. The associations were smaller but persisted with inclusion of controls. From 2000 to 2017, child health disparities slightly narrowed or remained stagnant among white, non-Hispanic black, and other Hispanic children but widened for Mexican origin children ( P < .05). Conclusion: Maternal education disparities in child health are wide and have persisted.

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