Children of farm workers are three times as likely as all other children and almost twice as likely as other poor children to be uninsured, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Children of farm workers face a variety of health challenges, according to background information in the article. Most are Latino, a group that already has suboptimal access to pediatric health services. In addition, Mexican American migrant children who move around the United States with their farm-worker parents are two to three times more likely to be rated in poor or fair health than non-migrant Mexican American children. Farm workers' children are often exposed to pesticides and are more likely to engage in dangerous agricultural work themselves.
"Health insurance improves children's access to and use of health care services, making children's health insurance an important proxy for children's health care access," the authors write. Roberto L. Rodriguez, M.D., M.P.H., of the University of Texas Medical BranchAustin and Dell Children's Medical Center of Central Texas and colleagues analyzed results of a national survey of 3,136 farm workers with children younger than 18 years. The parents reported demographic and social characteristics along with the health insurance status of their children (all of whom lived in the United States).
Among the farm-worker parents, 32 percent reported that their children were uninsured, including 45 percent of migrant-worker parents. Parents who were older, had less education, had spent less time in the United States and who lived in the Southeast or Southwest were more likely to have uninsured children.
"Our findings highlight the particular vulnerability of U.S. farm workers' children regarding health insurance coverage," the authors write. "These findings have important policy implications. They suggest that the low parental education among many farm workers as well as more recent immigrationwhich may in part reflect acculturationnegatively affect their children's health insurance status."
"These social disadvantages may warrant increased efforts to enroll and retain eligible children in health insurance programs. Outreach efforts would need to consider other barriers that impede insurance enrollment and retention, such as the complexity of applications, language barriers, the inaccessibility of enrollment sites in rural areas and parents' fear of using services or misunderstanding of eligibility guidelines," they conclude. "Efforts to address disparities in health insurance for farm workers' children may lead to better access to health care and better health."
(Arch Pediatr Adolesc Med. 2008;162:1175-1180. Available pre-embargo to the media at www.jamamedia.org.)
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