Health insurance across vulnerable ages: Patterns and disparities from adolescence to the early 30s
Health insurance across vulnerable ages: Patterns and disparities from adolescence to the early 30s
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DOI：
10.1542/peds.2006-1730
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发表时间：
2007-05-01
期刊：
影响因子：
8
通讯作者：
Irwin, Charles E., Jr.
中科院分区：
文献类型：
--
作者：
Adams, Sally H.;Newacheck, Paul W.;Irwin, Charles E., Jr.
OBJECTIVE.在所有年龄组中，年轻人的保险覆盖率最低。人们对从青春期到30岁出头的保险模式知之甚少。本研究的目的是评估从青春期到30年代初的健康保险模式和差异。我们分析了2002年和2003年全国健康访谈调查（年龄13-32岁; N = 48827）的数据。我们检查了公共和私人保险覆盖范围，并进行逻辑回归，以评估种族/民族和收入差距的覆盖范围。结果为13 - 32岁时的保险覆盖率。保险模式在各年龄段呈U形曲线。13至14岁的发病率最高，23至24岁最低，然后逐渐上升。私人保险费率模式相似;然而，公共保险的覆盖率随着年龄的增长而下降。在双变量分析中，黑人和西班牙裔群体的覆盖率低于白色群体，低收入和中等收入群体的覆盖率低于高收入群体。调整混杂变量后，除黑人和白色组之间的差异外，所有差异均保持显著性。18岁以后，所有群体都容易缺乏保险。25至26岁以上的发病率上升是由于私人保险的增加，而公共保险的减少是由于青春期的较高发病率没有完全恢复。覆盖青少年的公共项目的安全网在成年后消失，使年轻人变得脆弱，对于那些贫困和西班牙裔人来说，这个问题一直持续到30多岁。
OBJECTIVE. Young adults have the lowest rate of insurance coverage of any age group. Little is known about insurance patterns from adolescence through the early 30s. The objective of this study was to assess patterns and disparities in health insurance from adolescence through the early 30s.DESIGN. We analyzed data from the 2002 and 2003 National Health Interview Survey (ages 13-32; N = 48 827). We examined public and private insurance coverage and conducted logistic regression to evaluate racial/ethnic and income disparities in coverage. Outcomes were insurance coverage at ages 13 to 32.RESULTS. Insurance patterns follow a U-shaped curve across the age categories. Rates are highest at ages 13 to 14, lowest at ages 23 to 24, and then increase gradually. Private rate patterns are similar; however, public coverage decreases across ages. In bivariate analyses, black and Hispanic groups had lower coverage rates than the white group, and the low- and middle-income groups had lower rates than the high-income group. After adjustment for confounding variables, all disparities remained significant except for differences between the black and white groups.CONCLUSIONS. After age 18, all groups are vulnerable to lack of insurance. Rate increases beyond age 25 to 26 years are attributable to increases in private coverage, whereas decreases in public coverage account for the lack of a full recovery to the higher rates seen in adolescence. The safety net of public programs that cover adolescents disappears in young adulthood, leaving young adults vulnerable, a problem that persists into the 30s for those who are in poverty and those who are of Hispanic origin.