Children and the Elderly: Wealth Inequality Among America's Dependents.

Life cycle theory predicts that elderly households have higher levels of wealth than households with children, but these wealth gaps are likely dynamic, responding to changes in labor market conditions, patterns of debt accumulation, and the overall economic context. Using Survey of Consumer Finances data from 1989 through 2013, we compare wealth levels between and within the two groups that make up America's dependents: the elderly and child households (households with a resident child aged 18 or younger). Over the observed period, the absolute wealth gap between elderly and child households in the United States increased substantially, and diverging trends in wealth accumulation exacerbated preexisting between-group disparities. Widening gaps were particularly pronounced among the least-wealthy elderly and child households. Differential demographic change in marital status and racial composition by subgroup do not explain the widening gap. We also find increasing wealth inequality within child households and the rise of a "parental 1 %." During a time of overall economic growth, the elderly have been able to maintain or increase their wealth, whereas many of the least-wealthy child households saw precipitous declines. Our findings suggest that many child households may lack sufficient assets to promote the successful flourishing of the next generation.

Public Health Insurance and Health Care Utilization for Children in Immigrant Families.

Objectives To estimate the impacts of public health insurance coverage on health care utilization and unmet health care needs for children in immigrant families. Methods We use survey data from National Health Interview Survey (NHIS) (2001-2005) linked to data from Medical Expenditures Panel Survey (MEPS) (2003-2007) for children with siblings in families headed by at least one immigrant parent. We use logit models with family fixed effects. Results Compared to their siblings with public insurance, uninsured children in immigrant families have higher odds of having no usual source of care, having no health care visits in a 2 year period, having high Emergency Department reliance, and having unmet health care needs. We find no statistically significant difference in the odds of having annual well-child visits. Conclusions for practice Previous research may have underestimated the impact of public health insurance for children in immigrant families. Children in immigrant families would likely benefit considerably from expansions of public health insurance eligibility to cover all children, including children without citizenship. Immigrant families that include both insured and uninsured children may benefit from additional referral and outreach efforts from health care providers to ensure that uninsured children have the same access to health care as their publicly-insured siblings.

Adverse Childhood Experiences among Reproductive Age Women: Findings from the 2019 Behavioral Risk Factor Surveillance System.

INTRODUCTION: Adverse childhood experiences (ACEs) are associated with many negative health outcomes. Despite this well-documented association, most research on how health conditions affect women's preconception and perinatal health overlooks ACEs. METHODS: This study analyzes self-reported ACE history and health outcomes among young adults (ages 18-39) using data from the 2019 Behavioral Risk Factor Surveillance System. Our aims were to 1) assess differences by gender in overall ACE scores and specific ACEs; 2) identify trends in women's ACE scores by birth cohort; and 3) estimate the association of ACE scores with health conditions that increase risk for adverse perinatal outcomes. RESULTS: Findings include that women had higher overall ACE scores than men and that women were more likely to report experiencing seven of the eight ACEs queried. More than 23% of women respondents reported an ACE score of 4+, with a 3-percentage point difference between the youngest and oldest women in our sample. Compared with those reporting zero ACEs, women with four or more ACEs were almost four times as likely to report a history of depression and more than twice as likely to report fair or poor health, even after accounting for sociodemographic characteristics. Women with four or more ACEs were 62% more likely to have obesity, 41% more likely to report a hypertension diagnosis, and 36% more likely to report a diabetes diagnosis than those with zero ACEs. CONCLUSIONS: ACEs are a root cause in the development of adverse health conditions in young women, and their prevention should be central to policies aimed at improving women and children's well-being.

Marriage, Kids, and the Picket Fence? Household Type and Wealth among U.S. Households, 1989 to 2019.

Evidence on how parenthood impacts household wealth in the United States has been inconclusive, partially because previous studies have decontextualized parenthood from gender, marital, and relationship status. Yet, insights from economic sociology suggest that wealth-related behaviors are shaped by the intersection of identities, not by a binary classification of parental status. We examine net worth by the intersection of gender, parental, and relationship status during a period of increasing wealth inequality and family diversification. Using data from the Survey of Consumer Finances from 1989 through 2019, we show that aggregate comparisons between parents and non-parents mask substantial wealth variation across nine household types. Despite changing social selection into marriage and parenthood, married parents consistently held a wealth advantage over demographically similar adults in other household types. Married parents' wealth advantage descriptively arises from homeownership, perhaps because the combined spousal and parental identities are normatively and culturally associated with homeownership.

A Penny on the Dollar: Racial Inequalities in Wealth among Households with Children.

The dynamics of racial/ethnic wealth inequality among U.S. families with resident children (child households) have been understudied, a major oversight because of wealth's impact on child development and intergenerational mobility. Using data from the Survey of Consumer Finances (2004-2016), the authors find that wealth gaps between black and white households are larger in, and have grown faster for, child households relative to the general population. In contrast, black-white income gaps for child households have remained largely unchanged. Wealth trends for black and Hispanic child households have diverged, and by 2016, Hispanic child households had more net worth than black child households. Between 2004 and 2016, home ownership rates and home equity levels for black child households decreased, while educational debt increased. In 2016, black child households had just one cent for every dollar held by non-Hispanic white child households. These findings depict the extreme wealth fragility of black child households.

Health and Union Dissolution among Parenting Couples: Differences by Gender and Marital Status.

Poor health may destabilize romantic unions by impeding fulfillment of family responsibilities, increasing stress, and causing financial strain. We hypothesized that the associations of health characteristics with union stability for parenting couples vary by the gender of the partner in poor health and the couple's marital status because of gender and marital status differences in family responsibilities and health-related coping behaviors. Using longitudinal data from the Fragile Families and Child Wellbeing Study (n = 2,997), we examined how three health measures predicted union dissolution for urban married and cohabiting couples with young children. Fathers' depression at baseline predicted dissolution for all parenting couples, as did either partner developing depression between baseline and the following interview. For married parents, fathers' health-related work limitations and mothers' poor self-rated health also predicted dissolution. Associations between health conditions and dissolution differ by gender and marital status, possibly reflecting varying social norms about family responsibilities.

Health behaviors and union dissolution among parents of young children: Differences by marital status.

Previous research finds that marriage is associated with better health and lower mortality, and one of the mechanisms underlying this association is health-related selection out of marriage. Using longitudinal survey data from 2,348 couples from the Fragile Families and Child Wellbeing Study, we examine whether certain health behaviors-smoking and binge drinking-are associated with risk of union dissolution among couples with young children. We use discrete time hazard models to test whether associations between health behaviors and union dissolution differ between married and cohabiting parents. We find no statistically significant association between binge drinking and union dissolution for either cohabiting or married couples. Parental smoking, however, is associated with union dissolution. On average, married and cohabiting couples in which both parents smoke have a higher risk of union dissolution than couples in which neither parent smokes. Additionally, father's smoking (in couples in which the mother does not smoke) is associated with union dissolution, but only for married couples. These findings illustrate the importance of considering the health behaviors of both partners and provide further evidence of differences in union dissolution dynamics between married and cohabiting couples.

Health insurance coverage within sibships: prevalence of mixed coverage and associations with health care utilization.

An increasing proportion of children in the United States lives in families with complicated family structures and a mix of immigrant and US-born family members. Eligibility rules for health insurance coverage, however, were not designed with these families in mind. The result can be complicated insurance patterns among siblings within families, with some "sibships" only being partially-insured, and other sibships having both private and public coverage. We hypothesize that mixed coverage among siblings causes confusion and logistical difficulties for parents and may lead to less access to appropriate health care for their children. In this article, we use data from the 2009-2011 National Health Interview Survey (n = 51,418 children in 20,478 sibships) to present estimates of the prevalence of mixed health insurance coverage among siblings and describe the predictors of such coverage. We also use linked data from the 2001-2005 National Health Interview Survey and 2002-2007 Medical Expenditure Panel Survey (n = 17,871) to show how mixed coverage is related to health care utilization. We find that although few sibships are characterized by different health insurance coverage types, mixed coverage among siblings is far more common among families with mixed nativity status, and blended families with step- and half-siblings. In terms of outcomes, children living in sibships with mixed coverage have significantly lower odds of having a usual source of health care. We also consider whether the association between mixed insurance coverage and health care outcomes differs across particular combinations of insurance coverage. We find that both publicly-insured children who have uninsured siblings and privately-insured children with publicly-insured siblings are less likely to have a usual source of care than similar children with uniformly-insured siblings. Because a usual source of care is associated with better health care outcomes, we argue that policymakers should consider ways to reduce mixed coverage among children and families.

Health information-seeking in the digital age.

OBJECTIVE: The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source. PARTICIPANTS: First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study. METHODS: Students completed a survey questionnaire regarding information-seeking behaviors and Internet uses in domains including health. The authors used regression analyses to examine predictors of source-specific health information-seeking. RESULTS: Young women are much more likely than young men to seek health information. The characteristics associated with looking online for health information are different than those for using other information sources, and students who look online for health information also report greater use of other information sources. CONCLUSIONS: Although the Internet is an important source of health information for students, health professionals should be aware that not all students equally utilize this resource.