Access to Primary Care

“Health Care Access for Low-Income People: Significant Safety Net Gaps Remain.” Laurie E. Felland, Suzanne Felt-Lisk, and Megan McHugh, June 2004. Despite signs that low-income and uninsured people’s access to primary health care services has improved, serious gaps in care exist, especially for specialty physicians, mental health, and dental care according to findings from the Community Tracking Study. Key factors contributing to these gaps include declining private physician and dentist involvement, changes in funding and facilities, and more people in need. Community leaders have developed a variety of innovative strategies to add specialty, mental health, and dental services, but could benefit from more support from state and federal policymakers.

Obesity Prevention

“The Effect of Breast-Feeding With and Without Formula Use on the Risk of Obesity at 4 Years of Age.” Debra L. Bogen, Barbara H. Hanusa, and Robert C. Whitaker. Obesity Research, September 2004. While there have been many studies examining whether breastfeeding is associated with a reduced risk of childhood obesity, it has not been clear how long mothers need to breastfeed to reduce their child’s risk of obesity, and whether the use of formula in conjunction with breastfeeding lessens its protective effect. In this study of 73,000 low-income children, researchers found that for breastfeeding to reduce the risk of obesity in preschool children, mothers must breastfeed for at least four months without using formula or for at least six months if they are also formula feeding. Breastfeeding, of any duration, was not found to be protective against obesity among black children or among children whose mothers smoked during pregnancy.

Food Stamp Trends

"Trends in Food Stamp Participation Rates: 1999-2002." Karen Cunnyngham, September 2004. Notes that the rate of participation for all eligible individuals fell from 56 percent in 1999 to 53 percent in 2001 and then rose in 2002 by less than one percentage point to 54 percent. For many subgroups, participation followed the overall trend, falling from 1999 to 2001 and then rising in 2002. However, the participation rate for children fluctuated around 70 percent for the entire period; the rate for elderly individuals fell by four points from 1999 to 2002; and the rate for noncitizens rose by 9 points in 2000 and then fell 12 points from 2000 to 2002. Full report and technical appendices.

School Lunches

"Evaluation of the National School Lunch Program Application/Verification Pilot Projects." Various authors, June 2004. Millions of U.S. children participate in the National School Lunch Program each day, receiving free or reduced-price food that makes an important contribution to their overall nutrition. But concern has mounted that many approved as eligible may in fact be ineligible because their family income is too high. This study examined two new approaches to certifying eligibility: (1) up-front documentation, which required families to provide proof of income or receipt of public assistance at the time of application for assistance; and (2) graduated verification, which did not require income documentation but verified income for a sample of approved applications. The researchers found that neither approach had a significant deterrent effect, and both approaches created barriers for some eligible children.
"Volume III: Impacts on Participation"
"Volume IV: Analysis of Pilot Operations and Costs"
"Volume V: Analysis of Applications"

Health Care for Military Families

"Annual Report 2003: Results from the Health Care Survey of DoD Beneficiaries." Natalie Justh, Sylvia Kuo, Rebecca Nyman, Eric Schone, and Fabrice Smieliauskas, March 2004. This publication reports on a worldwide survey of military health system beneficiaries, including children, conducted each year under a mandate from Congress to ensure regular monitoring of beneficiaries' satisfaction with their health care options. In 2003, the survey also addressed policy issues such as the adequacy of the civilian network of care, beneficiaries' ratings of their pharmacy options, experiences of those with chronic conditions, reservists' health coverage, and a number of other topics.

Upcoming Presentations

Mark your calendar to attend one of our many presentations at the 2004 Association for Public Policy and Management research conference in Atlanta from October 28 to 30.

Plan to join us next month at the American Public Health Association annual meetings in Washington from November 6 to 10.