Children whose parents lack health insurance may miss out on routine care, even when the children themselves are covered, a new study finds.
Using data from a government survey of more than 43,000 U.S. households, researchers found that children and teenagers were least likely to have seen a doctor or dentist in the past year when they and their parents lacked health insurance.
However, gaps were also seen when parents were uninsured but had coverage for their children -- through, for example, the government-run State Children's Health Insurance Program (SCHIP).
Compared with children whose parents had health insurance, these children were almost one-third more likely to have no regular health provider. They were also 20 percent more likely to have missed out on at least one type of preventive health counseling -- like talking with a doctor about healthy eating and exercise.
Even when the researchers considered other factors -- like families' incomes and parents' education -- parents' insurance status was still connected to the likelihood of their children getting healthcare.
The findings point to the importance of health insurance for the entire family, according to the researchers, led by Dr. Jennifer E. DeVoe of Oregon Health and Science University in Portland.
SCHIP was developed to provide insurance for children from working families who cannot afford private insurance but earn too much to qualify for Medicaid, the healthcare coverage program for the poor.
And SCHIP has improved U.S. children's coverage rates, DeVoe and her colleagues write in the Annals of Family Medicine.
The vulnerability of children in this study that is due not only to their own coverage instabilities but also the lack of reliable coverage for parents, however, highlights the need to look beyond child-only insurance models in the longer term, they emphasize.
Of the 43,509, 2- to 17-year-olds in the study, about 74 percent were from families where all members had health insurance. In 8 percent of homes, both parents and children lacked coverage, while in 10 percent, children were covered but parents were not.
In those latter 10 percent of families, children were more than twice as likely to have spent part of the year uninsured, compared with those in families where all members had insurance.
For now, DeVoe and her team write, doctors can help by identifying parents and children who may qualify for Medicaid or SCHIP.
But in the longer term, they argue, ensuring universal access to health care services and recommended preventive care will require comprehensive reforms.
Keeping the entire family in mind when crafting any new reforms will be essential to achieving a sustainable health care system and the best possible health outcomes for our children.
SOURCE: Annals of Family Medicine, September/October 2009.