US: Children of the Working Poor Lack Health Care
By Alan Mozes
NEW YORK (Reuters Health) - Children of American working families living at or just slightly above the poverty line--the ''working poor''--are the most likely to fall through the cracks in the health care system, according to a recent study.
``Children in working poor families were far more likely to lack health insurance coverage and to experience disruptions in insurance coverage compared to children of non-working poor parents and compared to children in moderate to affluent families,'' said study lead author Dr. Sylvia Guendelman.
Guendelman and Dr. Michelle Pearl at the University of California at Berkeley analyzed data on close to 14,000 children of working poor, poor, and moderate to affluent families that had been collected in a 1997 US Census Bureau (news - web sites) ``National Health Interview Survey.''
They found that 16% of the working poor children who were in less than excellent health had not visited a doctor within the past year, compared to 12% of the poor and 9% of the moderate to affluent group. They also found that overall access to all types of health care was much more difficult for children of the working poor, who were less likely to have a regular source of care.
In addition, the researchers noted that children of the working poor were uninsured at four times the rate of the moderate to affluent children.
In 1996, the poverty line was defined as an income of $31,822 for a family of four. The study authors defined the working poor as earning less than 200% of the poverty level.
Guendelman and Pearl reported their results in the June issue of Archives of Pediatrics and Adolescent Medicine.
Despite the implementation of the federal Children's Health Insurance Program (CHIPS) in 1997--designed to provide insurance at the state level to about 5 million uninsured children of the working poor--barriers to enrollment still exist. Guendelman and Pearl stated that the program has suffered from insufficient outreach and too much red tape, forcing a large portion of eligible children to delay or completely miss receiving the care they need.
Guendelman told Reuters Health that about 25 million American children live in working families that earn less than 200% of the poverty line. And she suggested that federal welfare-to-work policies implemented over the past few years should take responsibility to ensure that these children get and are able to maintain health care coverage.
``The working poor have received far less attention than welfare folks, and studies such as mine begin to portray the realities of this often neglected population,'' Guendelman said. ''Our findings were not unexpected given that until recently poor working families were given few incentives and have not been eligible for means-tested programs such as Medicaid.''
SOURCE: Archives of Pediatric Adolescent Medicine 2001;155.651-658.