By Alison Lapp,
WASHINGTON — For most of us, an apple a day may keep the doctor away, but for America’s 8.4 million uninsured children, a visit to the doctor may be an important missing step toward healthy growth and development.
Most of those children shouldn’t have to worry about whether they’ll get care when they need it, according to a report released Tuesday by the Robert Wood Johnson Foundation, because as many as 70 percent of them are eligible for state health programs such as Medicaid.
"Uninsured kids are less likely to learn, they’ll be out of school more often and they’ll have problems they don’t have to have," U.S. Surgeon General Richard Carmona said in support of the health care research foundation’s outreach program, which provides a toll-free information line for parents wondering whether their children are eligible for state aid.
The report said an average of 245,647 North Carolina children — 12.3 percent of all residents under 18 — went without health insurance in 2002 and 2003. But according to the Durham-based N.C. Institute of Medicine, an estimated 192,000 children in North Carolina are currently eligible for state health programs but don’t use them.
Christopher Conover, a Duke professor who studies health inequalities, said the stigma attached to relying on public aid, or a simple lack of awareness about state programs, might prevent families from signing up.
Access to health care is important for children, who need immunizations and frequent preventative care, he said, and becomes even more vital in adolescence, when youths need contraceptive and reproductive health care. But uninsured children are 10 times more likely than their insured counterparts to miss out on needed health care, the foundation’s report said
Two programs in North Carolina, Medicaid and N.C. Health Choice for Children, cover uninsured children whose families earn up to twice the poverty level. In Durham County, the two programs cover between 2,500 and 2,700 of the more than 3,300 eligible children, according to statistics from the Durham County Health Department.
Susan Guptill, director of nursing for the department, said the county places brochures in doctors’ offices, sets up booths at health fairs and talks to physicians to help get the word out about the state programs.
Conover said public health officials need to use a variety of strategies to reach out to uninsured children and their families.
"There is no one silver bullet that if you use it, you’ll reach all the kids," he said, adding that research shows that providing outreach programs in emergency rooms is a good way to make contact with uninsured families because they disproportionately use emergency departments for primary health care services.
Guptill said her outreach teams work with emergency rooms in Durham, but that it is difficult to keep informational materials there because of high patient and staff turnover.
The outreach program, which has been in existence for about five years, has produced a slow but steady increase in state health program enrollment, she said, with more children signing up with each successive month.
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