Family Structure and the Treatment of Childhood Asthma

Published in: NBER Working Papers / (Cambridge, MA : National Bureau of Economic Research, Oct. 2007), p. 1-2, 6-43

Posted on RAND.org on January 01, 2007

by Alex Y. Chen, Jose J. Escarce

Read More

Access further information on this document at papers.nber.org

This article was published outside of RAND. The full text of the article can be found at the link above.

BACKGROUND: Family structure is known to influence children's behavioral, educational, and cognitive outcomes, and recent studies suggest that family structure affects children's access to health care as well. However, no study has addressed whether family structure is associated with the care children receive for particular conditions or with their physical health outcomes. OBJECTIVE: To assess the effects of family structure on the treatment and outcomes of children with asthma. METHODS: Our data sources were the 1996-2003 Medical Expenditure Panel Survey (MEPS) and the 2003 National Survey of Children's Health (NSCH). The study samples consisted of children 2-17 years of age with asthma who lived in single-mother or two-parent families. The authors assessed the effect of number of parents and number of other children in the household on office visits for asthma and use of asthma medications using negative binomial regression, and we assessed the effect of family structure on the severity of asthma symptoms using binary and ordinal logistic regression. Our regression models adjusted for sociodemographic characteristics, parental experience in child-rearing and in caring for an asthmatic child and, when appropriate, measures of children's health status. RESULTS: Asthmatic children in single-mother families had fewer office visits for asthma and filled fewer prescriptions for controller medications than children with two parents. In addition, children living in families with three or more other children had fewer office visits and filled fewer prescriptions for reliever and controller medications than children living with no other children. Children from single-mother families had more health difficulties from asthma than children with two parents, and children living with two or more other children were more likely to have an asthma attack in the past 12 months than children living with no other children. CONCLUSIONS: For children with asthma, living with a single mother and the presence of additional children in the household are associated with less treatment for asthma and worse asthma outcomes

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.