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Paul H. Wise, MD, MPH, Nina S. Wampler, DSc, MPH, Wendy Chavkin, MD, MPH and Diana Romero, PhD, MA

Paul H. Wise is with the Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, Mass. Nina S. Wampler is with the Division of American Indian and Alaska Native Programs, University of Colorado Health Science Center, Denver. Wendy Chavkin and Diana Romero are with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City.

Correspondence: Requests for reprints should be sent to Paul H. Wise, MD, MPH, Boston Medical Center, Department of Pediatrics, Maternity-4, One Boston Medical Center Pl, Boston, MA 02118 (e-mail: pwise{at}bu.edu).

Objectives. This study assessed chronic child illness among recipients of Temporary Assistance for Needy Families (TANF) benefits and poor families not receiving benefits.

Methods. Data from the 1998 National Health Interview Survey were used to examine chronic child illness, enrollment in TANF, health insurance status, and selected access indicators.

Results. One quarter of TANF-enrolled children had chronic illnesses. Unenrolled children were 3 times as likely as TANF-enrolled children to be uninsured. Among the chronically ill, 31.7% of unenrolled and 14.3% of enrolled children experienced gaps in insurance coverage that were associated with access barriers.

Conclusions. Welfare policies should consider the effects of chronic illness and gaps in insurance coverage on the health of poor children.

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