Medicaid expansion based on income and the subsidization of qualified health plan purchases within health insurance marketplaces were methods adopted by the Affordable Care Act (ACA) to address high rates of uninsured individuals. One year into the expansion, the rates of uninsured children significantly dropped and insured individuals were more likely to report being under regular medical care for a chronic condition. Yet Watts, a 2.5 sq. mile community in the south region of the City of Los Angeles, continues to experience significant disparities in health outcomes ranking in the top 5% most socially and environmentally vulnerable. In light of this social vulnerability, the study will explore the impacts of parents’ immigration status on their child’s perceived health and address fears of public charge. Historically public charge has been used to determine residency eligibility for people seeking admission into the US, it refers to an individual who is likely to become dependent on the government for subsistence through public cash assistance for income maintenance or institutionalized long term term care. The study will further assess environmental vulnerability by looking at rates of asthma and obesity among children in Watts.
In-person household survey of parents of children <18 years were conducted in the Watts community of South Los Angeles. Households were considered eligible if at least 1 child living in the home was 18 years or younger. Surveys were conducted in English or Spanish based on participant preference. The survey focused on parent rating of child’s health, asthma and obesity rates among children, as well as parents perception of public charge.
Preliminary results showed that 89.4% of the children in Watts are insured, of those 61% were covered by Medicaid and 13% received insurance through the ACA. Nearly half the residents (49%) rated their child’s health as less than excellent or very good. Only 3.2% of parents indicated they did not get medical care for their child because of fear it might affect their immigration status or that of a family member. 16% of children were diagnosed with asthma which is almost twice the national average and 28.6% were told by a healthcare provider that their child was overweight or obese. Further results are pending to determine if parent immigration status is related to lower health ratings of child and higher rates of asthma and obesity.
Self-rating of health is an independent predictor of higher mortality therefore it is really concerning that nearly half the parents rated their child’s health as less than excellent or very good. Considering the large percentage of children that are insured through Medical and the ACA it is important to advocate for continued government support of these programs. The majority of parents did not view medical care for their children as a public charge and only 3.2% did not get medical care for their child because of fear it might affect their immigration status. Many of the survey responses were collected over the last year and it is possible recent increased coverage of anti-immigration policies will contribute to increased fear of public services including Medi-Cal. Results are still pending to differentiate health outcomes of children living in Watts based on their parent’s immigration status.