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卫生保健需求。虽然经常作为一个组进行讨论，但这些 儿童有一系列不同的身体和精神疾病，如哮喘、注意力障碍、自闭症和 其他发育或学习迟缓。先前的研究发现，有特殊健康需求的人群 种族和少数民族儿童以及社会经济地位较低家庭的儿童 他们的非少数群体和更高SES的对应者。低社会地位儿童和少数族裔儿童也更有可能 接受不适当的诊断，经历更糟糕的健康结果，接受不充分或不满意的 治疗。为了减少有特殊卫生保健需求儿童(CSHN)的健康差距，家庭必须 能够利用支持子女的服务，减轻父母的压力、财务风险和 关心。然而，照顾CSHN的家庭在获得和协调支持方面往往面临挑战 这些挑战对社会和经济上的弱势家庭来说可能会加剧。虽然很多人 健康和收入政策针对的是高危人群，人们对现金和实物的有效性知之甚少 转移方案，以最大限度地减少与以下方面有关的家庭负担中与种族、民族或社会经济地位相关的差异 关爱CSHN。 这项研究将考察补充保障收入的作用，这是一项提供收入的经济状况调查计划 对于CSHN的家庭来说，在尽量减少种族、民族或社会经济地位相关的家庭负担方面的差异方面， 关爱CSHN。这项研究将利用全国特殊儿童调查进行量化分析 卫生保健需要确定不同种族和民族在护理负担和SSI使用方面的现有差异 照顾CSHN的少数族裔家庭和低社会保障家庭；隔离推动儿童和家庭特征 使用Oaxaca-Blinder分解方法确定护理负担和SSI收受方面的差异； 并使用工具变量策略来获得对以下因素的因果影响的估计 SSI现金福利减轻了照看负担方面的差距。这项研究将为决策者提供 评估现金转移在多大程度上改善低社会经济地位和少数族裔CSHN的健康和福祉的信息 并将为今后的研究分析奠定理论和方法基础 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结果。

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.