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State-level income inequality and family burden of US families raising children with special health care needs

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  • Parish, Susan L.
  • Rose, Roderick A.
  • Dababnah, Sarah
  • Yoo, Joan
  • Cassiman, Shawn A.

Abstract

Growing evidence supports the hypothesis that income inequality within a nation influences health outcomes net of the effect of any given household’s absolute income. We tested the hypothesis that state-level income inequality in the United States is associated with increased family burden for care and health-related expenditures for low-income families of children with special health care needs. We analyzed the 2005–06 wave of the National Survey of Children with Special Health Care Needs, a probability sample of approximately 750 children with special health care needs in each state and the District of Columbia in the US Our measure of state-level income inequality was the Gini coefficient. Dependent measures of family caregiving burden included whether the parent received help arranging or coordinating the child’s care and whether the parent stopped working due to the child’s health. Dependent measures of family financial burden included absolute burden (spending in past 12 months for child’s health care needs) and relative burden (spending as a proportion of total family income). After controlling for a host of child, family, and state factors, including family income and measures of the severity of a child’s impairments, state-level income inequality has a significant and independent association with family burden related to the health care of their children with special health care needs. Families of children with special health care needs living in states with greater levels of income inequality report higher rates of absolute and relative financial burden.

Suggested Citation

  • Parish, Susan L. & Rose, Roderick A. & Dababnah, Sarah & Yoo, Joan & Cassiman, Shawn A., 2012. "State-level income inequality and family burden of US families raising children with special health care needs," Social Science & Medicine, Elsevier, vol. 74(3), pages 399-407.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:3:p:399-407
    DOI: 10.1016/j.socscimed.2011.10.035
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    References listed on IDEAS

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    1. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
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    4. Parish, Susan L. & Rose, Roderick A. & Andrews, Megan E. & Shattuck, Paul T., 2009. "Receipt of professional care coordination among families raising children with special health care needs: A multilevel analysis of state policy needs," Children and Youth Services Review, Elsevier, vol. 31(1), pages 63-70, January.
    5. Subramanian, S. V. & Kawachi, Ichiro & Kennedy, Bruce P., 2001. "Does the state you live in make a difference? Multilevel analysis of self-rated health in the US," Social Science & Medicine, Elsevier, vol. 53(1), pages 9-19, July.
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    Cited by:

    1. Slayter, Elspeth, 2016. "Youth with disabilities in the United States Child Welfare System," Children and Youth Services Review, Elsevier, vol. 64(C), pages 155-165.
    2. Nidhiya Menon & Susan L. Parish & Roderick A. Rose, 2014. "The "State" of Persons with Disabilities in India," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 15(4), pages 391-412, November.
    3. Lightfoot, Elizabeth & Slayter, Elspeth, 2014. "Disentangling over-representation of parents with disabilities in the child welfare system: Exploring child maltreatment risk factors of parents with disabilities," Children and Youth Services Review, Elsevier, vol. 47(P3), pages 283-290.
    4. Slayter, Elspeth M. & Jensen, Jordan, 2019. "Parents with intellectual disabilities in the child protection system," Children and Youth Services Review, Elsevier, vol. 98(C), pages 297-304.

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