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Analysis Finds 'Deep Inequities' in Children's Health Coverage

Analysis  |  By Laura Beerman  
   October 10, 2022

A study reveals disparities across multiple dimensions.

new analysis finds deep inequities among U.S. children who lack health insurance by race, income, geography, and age at both the national and state levels. The study, conducted by the State Health Access Data Assistance Center (SHADAC) and funded by the Robert Wood Johnson Foundation (RWJF), is based on a national five-year data set.

In a press release, Colin Planalp, the report's lead author and SHADAC senior research fellow, noted: "Our study found clear inequities in health insurance coverage within all states." Planalp added: "Plenty of work is still needed to achieve goals of ensuring children have equitable access to health insurance and healthcare, but the high coverage rates among some groups prove that progress is possible."

  1. Uninsured rates for U.S. children differ based on age but hover on average around 5%.

The state data analysis showed that approximately 3.6 million children lacked health coverage between 2016 and 2020. Older children (ages 12 to 17) experienced the highest rate at 5.8%, followed by kids six to 11 (4.8%), and those younger than five (4.3%).

  1. Based on race, American Indian and Alaska Native, Latino, Native Hawaiian and Pacific Islander children fare worst.

Among these groups, the average uninsured rate is in some case more than 10% higher than for other races. The uninsured rate for American Indian and Alaska Native children (14.1%) is significantly higher than for children who are Black (4.2%), White (3.9%) or Asian (3.6%). Higher uninsured rates were also seen for children who are Latino (7.8%) and Native Hawaiian and Pacific Islander (6.0%).

  1. Children in the West were more likely to lack coverage than those in the Northeast, as were rural kids.

Six states rank highest for uninsured children, including: Texas (10.6%); Wyoming (9.3%); Alaska (8.4%); Arizona (8.2%); and Oklahoma and North Dakota (7.9%). Lack of coverage improved traveling East, with the lowest rates appearing in six states and the District of Columbia: Massachusetts (1.3%), Vermont (1.3%), DC (1.9%), Rhode Island (2.2%), and at 2.5% each, New York, West Virginia, and Iowa. More broadly, the uninsurance rate was 6.2% for kids in non-metro areas compared to 4.7% for those living in cities.

Andrea Ducas, senior program officer at RWJF, added: "Disparities in children's health insurance exacerbate inequities among populations that are often already disadvantaged. The data point to the need for more policy solutions at the state and national levels."

Laura Beerman is a contributing writer for HealthLeaders.

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