Jarlenski Marian, Baller Julia, Borrero Sonya, Bennett Wendy L
Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa; Center for Women's Health Research and Innovation, University of Pittsburgh, Pittsburgh, Pa.
Mathematica Policy Research, Washington DC.
Acad Pediatr. 2016 Mar;16(2):208-15. doi: 10.1016/j.acap.2015.07.008. Epub 2015 Aug 29.
To examine time trends in disparities in low-income children's health insurance coverage and access to care by family immigration status.
We used data from the National Survey of Children's Health in 2003 to 2011-2012, including 83,612 children aged 0 to 17 years with family incomes <200% of the federal poverty level. We examined 3 immigration status categories: citizen children with nonimmigrant parents; citizen children with immigrant parents; and immigrant children. We used multivariable regression analyses to obtain adjusted trends in health insurance coverage and access to care.
All low-income children experienced gains in health insurance coverage and access to care from 2003 to 2011-2012, regardless of family immigration status. Relative to citizen children with nonimmigrant parents, citizen children with immigrant parents had a 5 percentage point greater increase in health insurance coverage (P = .06), a 9 percentage point greater increase in having a personal doctor or nurse (P < .01), and an 11 percentage point greater increase in having no unmet medical need (P < .01). Immigrant children had significantly lower health insurance coverage than other groups. However, the group had a 14 percentage point greater increase in having a personal doctor or nurse (P < .01) and a 26 percentage point greater increase in having no unmet medical need (P < .01) relative to citizen children with nonimmigrant parents.
Some disparities in access to care related to family immigration status have lessened over time among children in low-income families, although large disparities still exist. Policy efforts are needed to ensure that children of immigrant parents and immigrant children are able to access health insurance and health care.
研究低收入儿童医疗保险覆盖情况及就医机会因家庭移民身份不同而产生的差异随时间的变化趋势。
我们使用了2003年至2011 - 2012年全国儿童健康调查的数据，其中包括83612名0至17岁、家庭收入低于联邦贫困线200%的儿童。我们考察了3种移民身份类别：父母为非移民的公民儿童；父母为移民的公民儿童；以及移民儿童。我们使用多变量回归分析来获取医疗保险覆盖情况和就医机会的调整后趋势。
从2003年到2011 - 2012年，所有低收入儿童在医疗保险覆盖和就医机会方面均有改善，无论其家庭移民身份如何。与父母为非移民的公民儿童相比，父母为移民的公民儿童医疗保险覆盖率提高了5个百分点（P = 0.06），拥有私人医生或护士的比例提高了9个百分点（P < 0.01），未满足医疗需求的比例降低了11个百分点（P < 0.01）。移民儿童的医疗保险覆盖率显著低于其他群体。然而，与父母为非移民的公民儿童相比，该群体拥有私人医生或护士的比例提高了14个百分点（P < 0.01），未满足医疗需求的比例降低了26个百分点（P < 0.01）。
尽管低收入家庭儿童中与家庭移民身份相关的就医机会方面仍存在巨大差异，但随着时间推移，其中一些差异已有所减少。需要通过政策努力确保移民父母的子女和移民儿童能够获得医疗保险和医疗服务。
