Research Activities, August 2013
Recent improvements in insurance coverage still leave disparities in pediatric health care for blacks and the poor
The proportion of uninsured children in the United States fell from 7.7 percent in 2002 to 6.3 percent in 2009, according to a new study. During this period, the proportion of privately insured children dropped from 65.3 percent to 60.6 percent, while children covered by public insurance rose from 27.0 percent to 33.1 percent.
These are findings from the 10th annual report on access to and use of health care in the United States for children and youth. The data are from AHRQ's Medical Expenditure Panel Survey (2002–2009) and Healthcare Cost and Utilization Project (2005 and 2009). AHRQ researchers Terceira A. Berdahl, Ph.D., Bernard S. Friedman, Ph.D., and colleagues found that the greatest progress in access to health care during the period was among Hispanic children, with those who were uninsured falling from 15.0 percent to 10.3 percent. In contrast, the percentage of uninsured black children remained essentially the same (declining slightly from 4.74 percent in 2002 to 4.13 percent in 2009). When insurance status was analyzed by income group, there were significant increases in public coverage over the study period among low-income children (from 57.1 percent to 64.3 percent) and middle-income children (from 12.6 percent to 16.5 percent), but not high-income children.
The researchers tracked other aspects of care as well over the 7-year period, for example, whether the child had a usual source of care; children's health care expenditures and out-of-pocket health care expenditures; and from 2005 to 2009, the number of overall hospital discharges for children; the leading diagnostic categories for these hospitalizations; and the annual number of preventable hospital admissions during the study period.
More details are in "Annual Report on Health Care for children and youth in the United States: Trends in racial/ethnic, income and insurance disparities over time, 2002–2009," by Dr. Berdahl, Dr. Friedman, Marie C. McCormick, M.D., Sc.D., and Lisa Simpson, M.B., B.Ch., M.P.H., in the May/June 2013 Academic Pediatrics 13(3), pp. 191-203. Reprints (Publication No. 13-R048) are available from AHRQ.