title: Trends in health insurance status of US children and their parents, 1998-2008.
abstract: In the United States (US), a parent's health insurance status affects their children's access to health care making it critically important to examine trends in coverage for both children and parents. To gain a better understanding of these health insurance trends, we assessed the coverage status for both children and their parents over an 11-year time period (1998-2008). We conducted secondary analysis of data from the nationally-representative Medical Expenditure Panel Survey. We examined frequency distributions for full-year child/parent insurance coverage status by family income, conducted Chi-square tests of association to assess significant differences over time, and explored factors associated with full-year insurance coverage status in 1998 and in 2008 using logistic regression. When considering all income groups together, the group with both child and parent insured decreased from 72.4 % in 1998 to 67.2 % in 2008. When stratified by income, the percentage of families with an insured child, but an uninsured parent increased for low-income families from 12.4 to 25.1 % and from 3.8 to 7.1 % for middle-income families when comparing 1998-2008. In regression analyses, family income remained the strongest characteristic associated with a lack of full-year health insurance. As future policy reforms take shape, it will be important to look beyond children's coverage patterns to assess whether gains have been made in overall family coverage.
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, 3181 Sam Jackson Rd, Mail Code FM, Portland, OR, 97239, USA, angierh@ohsu.edu.
authors.forename: Heather
authors.initials: H
authors.lastname: Angier
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: DeVoe
authors.forename: Carrie
authors.initials: C
authors.lastname: Tillotson
authors.forename: Lorraine
authors.initials: L
authors.lastname: Wallace
authors.forename: Rachel
authors.initials: R
authors.lastname: Gold
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000706:statistics & numerical data / Q000639:trends*; D007348:Insurance, Health / Q000706:statistics & numerical data / Q000639:trends*; D016015:Logistic Models; D010290:Parents; D012923:Social Class; D014481:United States