FAMILY CARE: California Lags Behind Nation
Low-income families in California are more likely to have poor health and less likely to have access to health care than are families in other states, according to a new Urban Institute survey. "Snapshots of America's Families" interviewed nearly 45,000 households nationally, more than 2,500 of them in California, and found that 12.2% of the state's low-income children are in fair to poor health, compared with 8.2% nationwide. Moreover, 18.5% of the state's parents reported they were "not confident" they could get medical care for their children, compared with 14.2% nationwide (Healy, Los Angeles Times, 1/26). "Despite the highest rate of public insurance in the country, or perhaps because of it, people in California reported some of the worst results when it came to access and health care. Policymakers in Sacramento need to look closely at the way they spend money on public children's health care programs," said David Grant, director of the Medical Community Assistance Project. He noted that compared with children from the other 12 states surveyed, California ranked lowest for confidence that low-income children could get health care, tied with Texas for having the most children in fair to poor health and tied with Alabama for the second-lowest rate of access to regular health care (MCAP, 1/25). For non-elderly adults, the study found that California ranked third from the bottom, with only 69% of its citizens privately insured. Among low-income adults that number dropped to 35%, the worst among states surveyed ("Snapshots," 1/25).
Across the States
The AP/Las Vegas Sun reports that the survey "found wide variations from state to state." Survey director Alan Weil said, "We have always known that some amount of state variation exists, but seeing the degree of it raises a lot of questions when we're moving into an era when states have more authority over social programs" (1/25). Nationally, approximately one in eight American children is without health insurance, while nearly one in every six non- elderly adults are in the same boat, according to the survey. However, the rate of uninsurance differed dramatically by family income: "21% of children in low-income families (below 200% of the federal poverty level) were uninsured, compared to 5% of children in families with higher incomes." But "39% of children in low-income families had some form of public coverage (primarily Medicaid and other state programs), versus with 5% of children in families with higher incomes." Further, 37% of nonelderly adults in low-income families were without insurance, whereas 9% of adults with higher incomes lacked coverage. Adults, however, were much less likely to be covered through public programs as only 20% of low-income and 3% of higher-income adults had public insurance. The survey also found that 8% of parents were "not confident that they could get necessary medical care" for their children, while 18% of adults and 6% of children reported having "no usual source of care." Twelve percent of adults and 5% of children were found to be in "fair or poor health." The researchers reported, however, that in all these categories, there were significant differences among income levels and geographic regions ("Snapshots," 1/25).
The Minneapolis Star Tribune reports that the survey is being billed "as one of the most comprehensive surveys of American families," and that "the research was designed to begin gauging the effects of welfare overhaul and the shift in funding social programs from the federal government to the states" (1/26). The "Snapshots of America's Families" survey is the 1997 results from the "National Survey of America's Families" that Westat is carrying out under subcontract with the Urban Institute. Thirteen states were studied, which together "are home to more than half the nation's population" (Urban release, 1/26). The full survey can be accessed at Urban Institute's Web site, www.urban.org.