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effects_of_family_structure_on_healthcare_coverage [2015/10/14 12:43]
cordell [1.1 Adults]
effects_of_family_structure_on_healthcare_coverage [2017/10/26 10:45] (current)
marri
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 ==========Effects of Family Structure on Healthcare Coverage========== ==========Effects of Family Structure on Healthcare Coverage==========
  
-//Original Research//: ​[[http://marri.us/policy-2013|U.SSocial Policy Dependence on the Family]]+Shifting marriage patterns have significantly altered the healthcare coverage of American adults. The majority of American adults (below age 65) receive health insurance through their Employer-Sponsored Coverage,​((Long,​ Michelle, Matthew Rae, Gary Claxton, and Anthony Damico, "​Trends in Employer-Sponsored Insurance Offer and Coverage Rates, 1999-2014,"​ Henry J. Kaiser Family Foundation (2016), available at [[https://www.kff.org/private-insurance/​issue-brief/​trends-in-employer-sponsored-insurance-offer-and-coverage-rates-1999-2014/​]].)) which generally extends to legal spouses and dependent childrenAs cohabitation rates rise, divorce becomes more commonplace,​ and young adults delay or forego marriage, ​the percentage of Americans eligible for employer coverage has diminished. ​
  
-To assess the role of family structure on policy outcomes, Dr. Henry Potrykus and Dr. Patrick Fagan of the Marriage ​and Religion Research Institute developed empirical models determining the influence of explanatory variables on various outcomes across the geographic-demographic areas of the U.S. These geographic-demographic areas are the Super Public Use Microdata Areas constructed by the U.S. Census. Potrykus and Fagan conclude that family structure always has a beneficial influence on policy outcomes. Family structure is a key factor in healthcare coverage.  ​+=====Marriage=====
  
-=====1. Public ​Health Insurance=====+Married individuals are more likely to have health insurance than their unmarried counterparts.((Peters,​ H. Elizabeth, Kosali Simon, and Jamie Rubenstein Taber, "​Marital Disruption and Health Insurance,"​ //​Demography//​ 51, no. 4 (2014): 1397-1421.)) Likewise, children living in intact married families were least likely to have had no health insurance, according to researchers at the Center of Disease Control.((Blackwell,​ Debra L, “Family Structure and Children'​s Health in the United States: Findings from the National Health Interview Survey, 2001-2007,​” //Vital and Health Statistics//,​ Series 10, Data from the National Health Survey 246 (2010): ​1-166.)) Dr. Henry Potrykus and Dr. Patrick Fagan of the Marriage and Religion Research Institute reported that the fraction of intact families in a geographic area has the largest attenuating influence on the proportion of 25- to 54-year-olds receiving public healthcare, even after controlling for demographics,​ education, and earnings. The same analysis found that the fraction of intact families has the second largest influence on the proportion of 25- to 54-year-olds with private healthcare coverage.((Henry Potrykus and Patrick F. Fagan, "U.S. Social Policy Dependence on the Family,"​ Marriage and Religion Research Institute (2013), available at [[http://​marri.us/​wp-content/​uploads/​U.S.-Social-Policy-Dependence-on-the-Family.pdf]].  
 +Zimmer, David M, "​Asymmetric Effects of Marital Separation on Health Insurance ​Among Men and Women,"​ //​Contemporary Economic Policy// 25, no. 1 (2007): 92-106.))
  
-====1.1 Adults====+=====Marital Disruption=====
  
-The fraction of intact families in the geographic area has the largest attenuating influence on the fraction of 25- to 54-year-olds receiving public healthcareThe fraction of intact families has a large, attenuating,​ precisely determinable((Precision has no formal meaningIt indicates how clearly determinable ​(distinguishable from zeroan influence on an outcome isPrecision is comparable ​to standard deviation. Low/ no precision indicates a high standard ​of deviation in which data points spread over a large range of valuesignifying that the influence ​of one variable over another is relatively uncertainHigh precision indicates a low standard ​of deviation in which data points hover around the meansignifying that the influence ​of one variable over another is relatively certain. For further elaboration see [[http://marri.frc.org/​get.cfm?​i=RS11E03| “Marriage and Economic Well-Being: The Economy of the Family Rises or Falls with Marriage”]])) influence on public healthcare receipt among 25- to 54-year-olds,​ even after applying controls ​for demographicseducation, and earnings.+Adults and children frequently lose their health insurance coverage following a marital dissolution.((Peters, H. Elizabeth, Kosali Simon, and Jamie Rubenstein Taber, "​Marital Disruption and Health Insurance,"​ //​Demography//​ 51, no. (2014): 1397-1421.)) According ​to Bridget Lavelle and Pamela Smock of the University ​of Michiganroughly 115,000 women each year lose their private health insurance due to a divorce, and more than half of these women end up uninsured.((Lavelle, Bridget, and Pamela J. Smock, "​Divorce and Women’s Risk of Health Insurance Loss," //​Journal ​of health and Social Behavior// 53, no4 (2012): 413-431.)) Women'​s overall rates of health insurance remained depressed ​for an average of two years following their divorce.((LavelleBridget, and Pamela JSmock, "​Divorce and Women’s Risk of Health Insurance Loss," //Journal of health and Social Behavior// 53, no. 4 (2012): 413-431.))
  
-The fraction of high school graduates in the geographic area has a similar influence. The fraction of college graduates in the geographic area has the next-largest attenuating influence on public healthcare recipiency among 25- to 54-year-olds when controlling only for demographics and education, but the influence is no longer determinable when controls for earnings are applied.+{{ :​women_s_health_insurance_type.png?​direct&​800 |Women'​s Health Coverage}} 
 +  
 +=====Foregoing Marriage=====
  
-The fraction of Hispanics and the fraction of blacks in the geographic area'population have the next-largest attenuating influenceafter controlling for demographics,​ education, and earnings. +While high divorce rates tend to hurt women’health insurance coveragedeclining marriage rates hurt men’s. Young women who obtained insurance through their husband’s employer in past years now obtain insurance through their own employer, and therefore are not significantly affected by the shifts away from marriage.((PercheskiChristine"Men as Dependents? Marriage and Changes in Health Insurance Coverage ​among Working-age Adults ​in the United States1988 to 2008," //Socius// 3 (2017): 2378023117709843.)) However, young men do not have any offsetting factors ​to supply ​for the benefits once supplied by marriage, and are increasingly left without their own employer ​coverage.((PercheskiChristine"Men as Dependents? Marriage ​and Changes ​in Health Insurance Coverage among Working-age Adults ​in the United States1988 to 2008," //Socius// 3 (2017): 2378023117709843.))
- +
-Urbanicity ​(i.e.population density) has a modestenhancing, but precisely determined influence on public healthcare receipt ​among 25to 54-year-olds. +
- +
-Income earned in prime age has an attenuating and precisely determined influence. +
-====1.2 Minors==== +
- +
-Public healthcare recipiency among minors is strongly attenuated by the level of familial intactness in an area. +
- +
-The fraction of families intact ​in the geographic area is second in its attenuating influence on the fraction of minors receiving public healthcare only to the fraction of the population that completed high school. Both have precisely determinable influences when controlling for demographiceducation, and economic factors. +
- +
-The fraction of the population that completed college also attenuates the proportion of minors receiving public healthcare, although less than high school education and family intactness do. Moreover, this influence becomes indeterminable when income is controlled for separately. +
- +
-The fraction of the population that is black has a precisely determinable,​ enhancing influence on minors'​ public health insurance recipiency. The fraction of the population that is Hispanic has no determinable influence on the fraction of minors having public health insurance. +
- +
-Urbanicity has a small but precisely determinable enhancing influence on the fraction of minors receiving public healthcare. +
- +
-The ratio of minors ​to adults has an attenuating influence on the fraction minors receiving public healthcare. Larger familiesin the dominant racial-ethnic population, show attenuated dependency.((This interpretation is born out in additional modeling in which we study the interaction between race and ethnicity and minor dependency. Enhanced dependency occurs in Hispanic and black sub-populations when there are more children. Attenuated dependency occurs otherwise.)) +
- +
-=====2. Private Healthcare===== +
- +
-====2.1 Adults==== +
- +
-The fraction of high school drop-outs in the geographic area has the largest influence on the fraction of 25- to 54-year-olds with private healthcare coverage. The influence is negative and precisely determinable with controls ​for demographics,​ education, and earnings: High school graduation has a positive influence. +
- +
-The fraction of intact families has the next-largest positiveprecisely determinable influence with the same controls applied. +
- +
-The fraction of college graduates has a larger positive, precisely deter-minable influence on private healthcare coverage for 25- to 54-year-olds,​ as well, but the influence'​s precision only persists under controls for demographics ​and education; when controls for earnings ​are added, the influence is undeterminable. +
- +
-The fractions of Hispanics and blacks in the geographic area have negative but precisely determinable influences on the fraction of 25-to 54-year-olds with private healthcare ​coverage. ​The influence of blacks is more modest than that of Hispanics. +
- +
-Income earned in prime age has a precisely determinable positive influence on the fraction of 25- to 54-year-olds with private healthcare coverage. +
- +
-====2.2 Minors==== +
- +
-The fraction of high school drop-outs and the fraction of intact families in the geographic area have off setting influences on the fraction of minors with private healthcare coverage. High school graduation has a larger influence than Belonging on the area's healthcare coverage levels. The influence of drop-outs and Belonging is precisely determinable with controls for demographicseducation, and earnings. +
- +
-The fraction of college graduates ​in a geographic area has a relatively small but positive and precisely determinable influence on the fraction of minors with private healthcare coverage, when controlling only for demo-graphics and education; however, when controls for earnings are added, college graduation has a marginal, negative influence on the fraction of minors with private healthcare coverage. +
- +
-The fractions of Hispanics and blacks ​in the geographic area's population have smallnegativebut precisely determinable influences on the fraction of minors with private healthcare coverage, with controls for demographics,​ education, and earnings active. +
- +
-Income earned in prime age has a precisely determinable influence; it has a positive influence on the fraction of minors with private healthcare coverage.+
  
 +{{ :​men_s_health_insurance_type.png?​direct&​800 |Men's Health Coverage}}