ABSTRACT
PURPOSE: The impact of health insurance on adolescent childbearing takes on increased salience in the context of the ongoing United States health care debate. Health insurance coverage is important for accessing health care services, including reproductive health services, yet prior research has not examined the association between insurance coverage and childbearing. Consequently, the role of insurance in the prevention of adolescent childbearing has been unclear. METHODS: Using three panels (2001, 2004, and 2008) of the nationally representative Survey of Income and Program Participation data, hierarchical multilevel logistic regression models test the association between pre-pregnancy health insurance coverage and childbearing for a sample of 7,263 unmarried adolescent women (aged 16-19 years), controlling for known correlates of adolescent childbearing. Analyses examine variations in the association based on family income. RESULTS: The odds of reporting childbearing were almost twice as great for adolescents who were uninsured compared with those who were insured before a pregnancy occurred. Interaction models demonstrate this effect for near-poor adolescents (who are less likely to have health insurance coverage) compared with poor and more advantaged adolescents. CONCLUSIONS: The findings of the current nationally representative study suggest that health insurance coverage is associated with a lower probability of childbearing for near-poor adolescents. Future research should examine potential mechanisms through which insurance coverage influences adolescent childbearing.
Subject(s)
Insurance Coverage/statistics & numerical data , Insurance, Health/statistics & numerical data , Medically Uninsured/statistics & numerical data , Pregnancy in Adolescence , Adolescent , Female , Health Services Accessibility/statistics & numerical data , Humans , Income/statistics & numerical data , Insurance Coverage/economics , Insurance, Health/economics , Poverty , Pregnancy , Reproductive Health Services/economics , Socioeconomic Factors , United States , Young AdultABSTRACT
Changes in individual or family circumstances cause many Americans to experience gaps and transitions in public and private health insurance. Using data from the 2004-2007 Survey of Income and Program Participation, this article updates earlier analyses of insurance gaps and transitions. Eighty-nine million people (one third of nonelderly Americans) were uninsured for at least 1 month during those 4 years. Approximately 23 million lost insurance more than once. The analyses call attention to the continuing instability and insecurity of health insurance, can inform implementation of national reforms, and establish a recent baseline that will be helpful in evaluating the reforms' effects on coverage stability.
Subject(s)
Health Benefit Plans, Employee/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Insurance Coverage/statistics & numerical data , Insurance, Health/statistics & numerical data , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Medicare/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Health Care Surveys , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Middle Aged , Patient Protection and Affordable Care Act , United States , Young AdultABSTRACT
This study assesses the stability of Americans' health insurance status over a four-year period. Relatively few Americans were continuously uninsured for the four years 1996 to 1999, but a sizable number of the uninsured lacked a stable source of coverage. At least as many people were repeatedly uninsured as experienced a single gap in otherwise stable coverage. Given these dynamics, policymakers should think of "uninsured" as referring not to people, but rather to gaps in coverage over time. Reforms that stop short of universal coverage should be evaluated in terms of their likely effects on the continuity and stability of coverage.
