ArticlePediatrics2022
Underinsurance Among Children in the United States.
Article in Pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Prevalence and Correlates of Families' Unmet Social Needs in Pediatric Primary Care Settings.Healthcare (Basel, Switzerland) · 2026Article
- Out-of-Pocket Costs and Health-Related Social Needs Among Households With Children.JAMA network open · 2026Article
- Confessions in Cases of Child Physical Abuse-A CAPNET Study.Academic pediatrics · 2026Article
- Variability in Insurance Adequacy for Children With Special Health Care Needs on Medicaid.JAMA health forum · 2025Article
- Childhood Underinsurance in Primary Care: A Practice-Based Study.Healthcare (Basel, Switzerland) · 2025Article
- Health Care Utilization and Family Frustration: Do Health Insurance Coverage and Medical Homes for US Children Matter?Maternal and child health journal · 2025Article
- Out-of-pocket costs, time burden, and caregiver quality of life associated with pediatric medically attended respiratory syncytial virus illnesses.Cost effectiveness and resource allocation : C/E · 2025Article
- A galvanizing event to promote improving health insurance.Journal of pediatric rehabilitation medicine · 2025Article
- Incidence of pediatric narcolepsy diagnosis and management: evidence from claims data.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Pediatric Population Management Classification for Children with Medical Complexity.Population health management · 2024Article
- Addressing Underinsurance for Children With Special Health Care Needs.JAMA network open · 2023Article
- Underinsurance Among Children With Special Health Care Needs in the United States.JAMA network open · 2023Article
- Consistency and Adequacy of Public and Commercial Health Insurance for US Children, 2016 to 2021.JAMA health forum · 2023Article
- Insurance Status and Tumor Necrosis Factor Inhibitor Initiation Among Children With Juvenile Idiopathic Arthritis in the CARRA Registry.The Journal of rheumatology · 2023Article
- Pediatric COVID-19 Health Disparities and Vaccine Equity.Journal of the Pediatric Infectious Diseases Society · 2022Article
- Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea.Children (Basel, Switzerland) · 2022Article
- The impact of COVID-19 on children's lives in the United States: Amplified inequities and a just path to recovery.Current problems in pediatric and adolescent health care · 2022Article
- Insurance Delays in Initiation of Tumor Necrosis Factor Inhibitors in Children With Juvenile Idiopathic Arthritis.JAMA network open · 2022Article
- Management of Chronic Migraine in Children and Adolescents: Where are We in 2022?Pediatric health, medicine and therapeutics · 2022Review
- Self-Reported Well-Being of Family Caregivers of Children with Medical Complexity.Academic pediatricsArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe describe the change in the percentage of children lacking continuous and adequate health insurance (underinsurance) from 2016 to 2019. We also examine the relationships between child health complexity and insurance type with underinsurance.
methodsSecondary analysis of US children in the National Survey of Children's Health combined 2016-2019 dataset who had continuous and adequate health insurance. We calculated differences in point estimates, with 95% confidence intervals (CIs), to describe changes in our outcomes over the study period. We used multivariable logistic regression adjusted for sociodemographic characteristics and examined relationships between child health complexity and insurance type with underinsurance.
resultsFrom 2016 to 2019, the proportion of US children experiencing underinsurance rose from 30.6% to 34.0% (+3.4%; 95% CI, +1.9% to +4.9%), an additional 2.4 million children. This trend was driven by rising insurance inadequacy (24.8% to 27.9% [+3.1%; 95% CI, +1.7% to +4.5%]), which was mainly experienced as unreasonable out-of-pocket medical expenses. Although the estimate of children lacking continuous insurance coverage rose from 8.1% to 8.7% (+0.6%), it was not significant at the 95% CI (-0.5% to +1.7%). We observed significant growth in underinsurance among White and multiracial children, children living in households with income ≥200% of the federal poverty limit, and those with private health insurance. Increased child health complexity and private insurance were significantly associated with experiencing underinsurance (adjusted odds ratio, 1.9 and 3.5, respectively).
conclusionsUnderinsurance is increasing among US children because of rising inadequacy. Reforms to the child health insurance system are necessary to curb this problem.
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