The role of state policies and programs in buffering the effects of poverty on children's immunization receipt.
M L Mayer,
S J Clark,
T R Konrad,
V A Freeman and
R T Slifkin
Department of Pediatrics, Stanford University, Calif., USA. mmayer@email.unc.edu
OBJECTIVES: This study assessed the influence of public policieson the immunization status of 2-year old children in the UnitedStates. METHODS: Up-to-dateness for the primary immunizationseries was assessed in a national sample of 8100 children fromthe 1988 National Maternal and Infant Health Survey and its1991 Longitudinal Follow-Up. RESULTS: Documented immunizationrates of this sample were 33% for poor children and 44% forothers. More widespread Medicated coverage was associated withgreater likelihood of up-to-dateness among poor children. Up-to-datenesswas more likely for poor children with public rather than privatesources of routine pediatric care, but all children living instates where most immunizations were delivered in the publicsector were less likely to be up to date. Poor children in statewith partial vaccine replacement programs were less likely tobe up to date than those in free-market purchase states. CONCLUSIONS:While state policies can enhance immunization delivery for poorchildren, heavy reliance on public sector immunization doesnot ensure timely receipt of vaccines. Public- and private-sectorcollaboration is necessary to protect children from vaccine-preventablediseases.
This article has been cited by other articles:
N. J. Allred, K. G. Wooten, and Y. Kong The Association of Health Insurance and Continuous Primary Care in the Medical Home on Vaccination Coverage for 19- to 35-Month-Old Children
Pediatrics,
February 1, 2007;
119(Supplement_1):
S4 - S11.
[Abstract][Full Text][PDF]
K. J. Dombkowski, P. M. Lantz, and G. L. Freed Role of Health Insurance and a Usual Source of Medical Care in Age-Appropriate Vaccination
Am J Public Health,
June 1, 2004;
94(6):
960 - 966.
[Abstract][Full Text][PDF]
M. A. Schillaci, H. Waitzkin, E. A. Carson, C. M. Lopez, D. A. Boehm, L. A. Lopez, and S. F. Mahoney Immunization Coverage and Medicaid Managed Care in New Mexico: A Multimethod Assessment
Ann. Fam. Med,
January 1, 2004;
2(1):
13 - 21.
[Abstract][Full Text][PDF]
D. L. Langkamp, S. Hoshaw-Woodard, M. E. Boye, and S. Lemeshow Delays in Receipt of Immunizations in Low-Birth-Weight Children: A Nationally Representative Sample
Arch Pediatr Adolesc Med,
February 1, 2001;
155(2):
167 - 172.
[Abstract][Full Text][PDF]
J. J. Cotter, K. A. McDonald, D. A. Parker, D. K. McClish, C. B. Pugh, V. E. Bovbjerg, G. A. Tipton, L. F. Rossiter, and W. R. Smith Effect of Different Types of Medicaid Managed Care on Childhood Immunization Rates
Eval Health Prof,
December 1, 2000;
23(4):
397 - 408.
[Abstract][PDF]
J. M. Cowell and M. E. Cowell Immunization Rates: A Community Assessment Approach for Diagnosis
The Journal of School Nursing,
December 1, 1999;
15(5):
40 - 43.
[Abstract][PDF]