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

了解补充保障收入对减少有特殊医疗保健需求的儿童家庭的照护负担差异的影响

基本信息

批准号：
10112307
负责人：
Stephanie Rennane
金额：
$ 9.64万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-02-20 至 2022-12-31
项目状态：
已结题

项目摘要

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.

大约五分之一的儿童有特殊的医疗保健需求。虽然经常作为一个群体进行讨论，但这些儿童有多种身体和精神疾病，如哮喘、注意力障碍、自闭症和其他发育或学习延迟。先前的研究发现，特殊健康需求的患病率较高种族和族裔少数儿童以及低社会经济地位（SES）家庭的儿童与他们的非少数族裔和社会经济地位较高的同行。低社会经济地位和少数民族儿童也被发现更有可能接受不适当的诊断、经历更糟糕的健康结果以及接受不充分或不满意治疗。为了减少有特殊医疗保健需求的儿童 (CSHN) 的健康差异，家庭必须能够利用支持子女的服务并减轻父母的压力、财务风险和负担关心。然而，照顾 CSHN 的家庭经常面临获取和协调支持性支持的挑战。对于社会和经济弱势家庭来说，这些挑战可能会加剧。虽然很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、民族或社会经济地位相关的家庭负担差异关心 CSHN。本研究将探讨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向 CSHN 家庭提供帮助，尽量减少种族、族裔或社会经济地位相关的家庭负担差异关心 CSHN。该研究将利用全国特殊儿童调查进行定量分析医疗保健需要确定不同种族和民族之间护理负担和 SSI 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；隔离儿童和家庭的驱动特征使用 Oaxaca-Blinder 分解方法确定护理负担和 SSI 收据方面的差异；并采用工具变量策略来估计因果影响的程度 SSI 现金福利减轻了护理负担的差异。这项研究将为决策者提供用于评估现金转移对低社会经济地位和少数民族 CSHN 的健康和福祉改善程度的信息及其家人，为今后的研究分析打下理论和方法基础。政策可以通过这些机制改善这一弱势群体的家庭和儿童健康状况。