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Author: Irvin, Carol V.
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Irvin, Carol V. |
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Determinants of Timely Preventative Care and Immunizations Ph.D. Dissertation, The University of Wisconsin - Madison, 1994 Cohort(s): Children of the NLSY79, NLSY79 Publisher: UMI - University Microfilms, Bell and Howell Information and Learning Keyword(s): Birthweight; Child Health; Deviance; Health Care; Household Composition; Modeling, Probit; Poverty; Pre-natal Care/Exposure; Pre/post Natal Behavior; Pre/post Natal Health Care; Regions The failure of the United States health system's to adequately care for all children is revealed in lower than desired immunization rates among preschoolers. In 1985 only 49 percent of nonwhite preschoolers were fully immunized against diphtheria, pertussis, and tetanus (DPT); DPT immunization coverage among white preschoolers was 64 percent. This study first develops a simple two-period model of the household's demand for infant preventive care. The model demonstrates that the household bases its decision to purchase well-baby care on the impact that the child's health has on future family income and the trade-offs between current and future consumption. Using data from the National Longitudinal Survey of Youth, this study initially uses a binary probit model, and simulated probabilities based on the model, to analyze the timing of the child's first well-baby care visit. Surprising results include the marginal importance of family income and the insignificance of the type of insurance covering the infant. While economic barriers do not appear to exist, other barriers closely associated with the household's economic status, such as race and ethnicity, do influence which children will receive timely care. One predictor of delayed infant preventive care not typically analyzed in the economic literature is the presence of the infant's maternal grandparents. Low health endowment and illness are also significant barriers. This result supports the theoretical interpretation that the child's health endowment influences the efficiency of preventive care in producing health. Immunizations are commonly administered during well-baby care visits. When visits are delayed, immunization is delayed. An ordered probit model, a bivariate probit model, and simulated probabilities from the bivariate model all indicate that the child's DPT immunization status is not determined by household income or insurance coverage. These results contradict the descript ive work of child advocates and clinicians. The results of this study suggest that the current administration's vaccine proposal is misguided in its belief that poverty alone leads to inadequately immunized children. Barriers to immunization are low health endowments, rural residence, and mothers who are single, young, and care for a number of children. Dissertation Abstracts International, VOL. 54-10A, Page 3818. |
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Bibliography Citation
Irvin, Carol V. Determinants of Timely Preventative Care and Immunizations. Ph.D. Dissertation, The University of Wisconsin - Madison, 1994. |