Robert Wood Johnson Foundation Clinical Scholars Program, Center for Child and Community Health Research, University of Michigan, Mason F Lord Bldg, Ste. 4200, 5200 Eastern Ave, Baltimore, MD 21224, USA.
Matern Child Health J. 2012 Apr;16(3):735-43. doi: 10.1007/s10995-011-0779-8.
The objectives of this study were to (1) measure health insurance coverage and continuity across generational subgroups of Latino children, and (2) determine if participation in public benefit programs is associated with increased health insurance coverage and continuity. We analyzed data on 25,388 children income-eligible for public insurance from the 2003 to 2004 National Survey of Children's Health and stratified Latinos by generational status. First- and second-generation Latino children were more likely to be uninsured (58 and 19%, respectively) than third-generation children (9.5%). Second-generation Latino children were similarly likely to be currently insured by public insurance as third-generation children (61 and 62%, respectively), but less likely to have private insurance (19 and 29%, respectively). Second-generation Latino children were slightly more likely than third-generation children to have discontinuous insurance during the year (19 and 15%, respectively). Compared with children in families where English was the primary home language, children in families where English was not the primary home language had higher odds of being uninsured versus having continuous insurance coverage (OR: 2.19; 95% CI [1.33-3.62]). Among second-generation Latino children, participation in the Food Stamp (OR 0.26; 95% CI [0.14-0.48]) or Women, Infants, and Children (OR 0.40; 95% CI [0.25-0.66]) programs was associated with reduced odds of being uninsured. Insurance disparities are concentrated among first- and second-generation Latino children. For second-generation Latino children, connection to other public benefit programs may promote enrollment in public insurance.
(1) 测量拉丁裔儿童在各世代亚组中的医疗保险覆盖范围和连续性;(2) 确定参与公共福利计划是否与增加医疗保险覆盖范围和连续性有关。我们分析了 2003 年至 2004 年全国儿童健康调查中 25388 名符合公共保险条件的儿童的数据,并按世代地位对拉丁裔进行分层。第一代和第二代拉丁裔儿童未参保的比例(分别为 58%和 19%)高于第三代儿童(9.5%)。第二代拉丁裔儿童同样可能正在参加公共保险(分别为 61%和 62%),但参加私人保险的比例较低(分别为 19%和 29%)。第二代拉丁裔儿童在一年内保险中断的可能性略高于第三代儿童(分别为 19%和 15%)。与家中主要语言为英语的儿童相比,家中主要语言不是英语的儿童未参保的可能性更高,而连续参保的可能性更低(OR:2.19;95%CI[1.33-3.62])。在第二代拉丁裔儿童中,参与食品券(OR 0.26;95%CI[0.14-0.48])或妇女、婴儿和儿童计划(OR 0.40;95%CI[0.25-0.66])与未参保的可能性降低有关。保险差距集中在第一代和第二代拉丁裔儿童中。对于第二代拉丁裔儿童而言,与其他公共福利计划的联系可能有助于他们参加公共保险。