Understanding the Impact of Supplemental Security Income on Reducing Disparities in Caregiving Burden for Families of Children with Special Health Care Needs

大约五分之一的儿童有特殊的保健需要。虽然经常作为一个群体进行讨论， 儿童有各种各样的身体和精神状况，如哮喘、注意力障碍、自闭症， 其他发育或学习延迟。先前的研究发现， 少数种族和族裔儿童以及社会经济地位低的家庭中的儿童， 他们的非少数民族和更高的社会经济地位的同行。低社会经济地位和少数民族儿童也更有可能 接受不适当的诊断，经历更糟糕的健康结果，并接受不充分或不满意的治疗， 治疗为了减少有特殊医疗保健需求（CSHN）的儿童的健康差异，家庭必须 能够利用支持其子女的服务，减轻父母的压力，财务风险和负担， 在乎然而，照顾CSHN的家庭往往在获得和协调支持方面面临挑战。 这些挑战对于社会和经济弱势家庭来说可能会加剧。虽然许多 健康和收入政策针对的是高危人群，但人们对现金和实物的有效性知之甚少 转移计划，以最大限度地减少种族，民族或SES相关的家庭负担的差异， 照顾CSHN 这项研究将探讨的作用，补充保障收入，一个手段测试计划提供收入 CSHN的家庭，在尽量减少种族，民族或SES相关的家庭负担的差异， 照顾CSHN这项研究将利用全国有特殊疾病儿童调查进行定量分析。 卫生保健需要确定不同种族和民族之间SSI的负担和使用方面的现有差异 照顾CSHN的少数民族家庭和低社会经济地位家庭;孤立儿童和家庭特征， 使用Oaxaca-Blinder分解方法确定的住院负担和SSI接收的差异; 并采用工具变量策略，以获得估计的因果影响的程度， 社会保险现金福利减轻了抚养负担方面的差距。这项研究将为决策者提供 评估现金转移如何改善低社会经济地位和少数CSHN的健康和福祉的信息 及其家人，并为未来分析这些问题的研究奠定理论和方法论基础 政策可通过哪些机制改善这一弱势群体的家庭和儿童健康成果。

Approximately one in five children has a special health care need. While often discussed as one group, these children have a diverse set of physical and mental conditions such as asthma, attention disorders, autism, and other developmental or learning delays. Prior research finds a higher prevalence of special health needs among racial and ethnic minority children and children in families of low socioeconomic status (SES) compared with their nonminority and higher-SES counterparts. Low-SES and minority children have also been found more likely to receive inappropriate diagnoses, experience worse health outcomes, and receive inadequate or unsatisfactory treatment. To reduce disparities in the health of children with special health care needs (CSHN), families must be able to utilize services that support their children and reduce parental stress, financial risk, and burden of care. However, families caring for CSHN often face challenges in accessing and coordinating supportive services, and these challenges can be exacerbated for socially and economically vulnerable families. While many health and income policies target at-risk populations, little is known about the effectiveness of cash and in-kind transfer programs in minimizing racial, ethnic or SES-related disparities in the familial burden associated with caring for CSHN. This study will examine the role of Supplemental Security Income, a means-tested program providing income to families of CSHN, in minimizing racial, ethnic or SES-related disparities in the familial burden associated with caring for CSHN. The study will conduct quantitative analyses using the National Survey of Children with Special Health Care Needs to identify existing differences in caregiving burden and use of SSI across racial and ethnic minority families and low-SES families who are caring for CSHN; isolate child and family characteristics that drive the identified differences in caregiving burden and SSI receipt using a Oaxaca-Blinder Decomposition method; and employ an instrumental variables strategy to obtain an estimate of the causal impact of the extent to which SSI cash benefit mitigates disparities in caregiving burden. This research will provide decision makers with information to assess how well a cash transfer improves the health and well-being of low-SES and minority CSHN and their families, and will lay a theoretical and methodological foundation for future research analyzing the mechanisms through which policy can improve family and child health outcomes for this vulnerable population.