National Survey Of America's Families Research Articles

Nonparental child care during nonstandard hours: Does participation influence child well-being?

Over the last three decades there has been a rise in the number of workers employed during nonstandard (evening and overnight) hours; accompanying this trend has been a renewed interest in documenting the well-being of these workers and their families. However, no work has considered how participation in nonparental child care during nonstandard hours is associated with child development That is the aim of the current paper. Using repeated cross-sectional data from the 1999 and 2002 National Survey of America's Families (NSAF), this paper investigates the relationship between participation in nonstandard hours of nonparental child care (‘nonstandard child care’) and child well-being. I begin this investigation by classifying children as participants or nonparticipants in nonstandard child care; next, I specify a child production function to estimate the relationship between nonstandard child care and child well-being. I find a generally negative relationship between nonstandard child care and cognitive, behavioral, and contemporaneous physical well-being measures. Mechanisms analyses suggest this relationship is driven by exposure to low-quality, unpredictable care arrangements.

The impact of CHIP on children's insurance coverage: an analysis using the National Survey of America's Families.

To assess the impact of the Children's Health Insurance Program (CHIP) on the distribution of health insurance coverage for low-income children. The primary data for the study were from the 1997, 1999, and 2002 National Survey of America's Families (NSAF), which includes a total sample of 62,497 children across all 3 years, supplemented with data from other data sources. The study uses quasi-experimental designs and tests the sensitivity of the results to using instrumental variable and difference-in-difference approaches. A detailed Medicaid and CHIP eligibility model was developed for this study. Balanced repeated replicate weights were used to account for the complex sample of the NSAF. Descriptive and multivariate analyses were conducted. The results varied depending on the approach utilized but indicated that the CHIP program led to significant increases in public coverage (14-20 percentage points); and declines in employer-sponsored coverage (6-7 percentage points) and in uninsurance (7-12 percentage points). The estimated share of CHIP enrollment attributable to crowd-out ranged from 33 to 44 percent. Smaller crowd-out effects were found for Medicaid-eligible children. Implementation of the CHIP program resulted in large increases in public coverage with estimates of crowd-out consistent with initial projections made by the Congressional Budget Office. This paper demonstrates that public health insurance expansions can lead to substantial reductions in uninsurance without causing a large-scale erosion of employer coverage.

Racial Inequality in Receiving Transitional Support Services and Being Sanctioned Among TANF Recipients: A Group Threat Hypothesis

ABSTRACT This study investigates whether race or ethnicity is a factor that affects the chances of Temporary Assistance for Needy Families (TANF) recipients receiving three transitional supportive services—child-care subsidy, transitional Medicaid, and transportation/rent assistance—as well as being sanctioned. A sample of 676 adult parents who left TANF in 1998 or 1999 was analyzed with logistic regressions, using a national data set, The National Survey of America's Families (NASF) 1999. The results show that Hispanic recipients were less likely than White recipients to receive transportation/rent assistance and that African American recipients were less likely than White recipients to receive transitional Medicaid. Also, a state's high percentage of Hispanics reduced recipients' chances of receiving any three transitional support services in that state, and African American recipients were more likely than White recipients to be sanctioned. Transportation/rent assistance was likely to be provided to those who were single parents, and having little work experience was most likely a participant's reason for being sanctioned. Policy implications are discussed.

Associations Between Housing Instability and Food Insecurity With Health Care Access in Low-Income Children

Homelessness and hunger are associated with poor health care access among children. Housing instability and food insecurity represent milder and more prevalent forms of homelessness and hunger. The aim of this study was to determine the association between housing instability and food insecurity with children's health care access and acute health care utilization. We conducted a cross-sectional analysis of 12,746 children from low-income households included in the 2002 National Survey of America's Families (NSAF). In multivariate models controlling for important covariates, we measured the association between housing instability and food insecurity with 3 health care access measures: 1) no usual source of care, 2) postponed medical care, and 3) postponed medications. We also measured 3 health care utilization measures: 1) not receiving the recommended number of well-child care visits, 2) increased emergency department visits, and 3) hospitalizations. Our analysis showed that 29.5% of low-income children lived in households with housing instability and 39.0% with food insecurity. In multivariate logistic regression models, housing instability was independently associated with postponed medical care, postponed medications, and increased emergency department visits. Food insecurity was independently associated with no usual source of care, postponed medical care, postponed medications, and not receiving the recommended well-child care visits. Families that experience housing instability and food insecurity, without necessarily experiencing homelessness or hunger, have compromised ability to receive adequate health care for their children. Policy makers should consider improving programs that decrease housing instability and food insecurity, and clinicians should consider screening for housing instability and food insecurity so as to provide comprehensive care.

Social Capital and Adolescent Well-Being in a National Sample

Using data from the 1999 National Survey of America's Families (NSAF) on 11,809 boys and girls aged 12 to 17 years, the present study examined measures of adolescent social integration and the availability of community programs against the outcome measures of the Child Behavioral and Emotional Problems Scale (CBEPS) and the Child School Engagement Scale (CSES). On ordinary least squares regression analysis, adolescent participation in an organized activity, the adolescent's not changing schools, and a community program targeting adolescent pregnancy, drugs, or crime were significantly associated with higher scores on both scales. Adolescent employment was associated with a lower CSES score and had no effect on CBEPS. Neither residential stability (years in the home) nor parental religious attendance had any effect on the outcomes, but parental volunteerism was associated with a higher CSES score. The findings may be useful for the design of community programs targeting adolescents in particular because the NSAF has a focus on low-income families.

Reexamining the Effects of Family Structure on Children's Access to Care: The Single‐Father Family

To examine the effects of family structure, focusing on the single-father family, on children's access to medical care. The 1999 and 2002 rounds of the National Survey of America's Families (NSAF) including 62,193 children ages 0-17 years. We employ a nationally representative sample of children residing in two-parent families, single-mother families, and single-father families. Multivariate logistic regression is used to examine the relationship between family structure and measures of access to care. We estimate stratified models on children below 200 percent of the federal poverty threshold and those above. We combine data from the Focal Child and Adult Pair modules of the 1999 and 2002 waves of the NSAF. Children who reside in single-father families exhibit poorer access to health care than children in other family structures. The stratified models suggest that, unlike residing in a single-mother family, the effects of residence in a single-father family do not vary by poverty status. Children in single-father families may be more vulnerable to health shocks than their peers in other family structures.

What's Driving the Downward Trend in Employer‐Sponsored Health Insurance?

We investigate the factors driving the downward trend in employer sponsored health insurance (ESI) coverage between 1999 and 2002 for low- and middle-income workers, and assess their insurance options in the absence of ESI coverage. We use the 1999 and 2002 rounds of the National Survey of America's Families (NSAF), supplemented with ESI premiums from the Medical Expenditure Panel Survey, as well as other state- and county-level data from a variety of sources. The sample includes workers between the ages of 19 and 64. We first estimate linear probability models of the probability of having an ESI offer and, for those with an offer, the probability of taking up ESI coverage, using two-stage least square regression on the 2002 worker sample. We then use Oaxaca-Blinder regression-based decomposition methods to identify the factors that explain the changes in ESI offer and take-up between 1999 and 2002. We find that while low-income workers are more likely to be uninsured and are most vulnerable to the loss of ESI coverage, many middle-income workers are also in a precarious position when faced with the loss of ESI coverage. Many low- and middle-income workers have few coverage options in the absence of ESI. This is particularly problematic for low-income workers: only 13 percent have a spouse with an ESI offer and the nongroup premium they face increased at a much higher rate than for middle-income workers. Finally, we find that the drop in ESI offers between 1999 and 2002 was driven largely by changes in nature of the workers' jobs, while the drop in ESI take-up was driven largely by rising ESI premiums. Policies that shore up the ESI system are important for both low- and middle-income workers, as both are vulnerable to a loss of insurance coverage in the absence of ESI. Over time, the potential coverage options available to low- and middle-income workers in the absence of ESI have narrowed as nongroup premiums have increased. While public coverage has provided some protection from that increase for low-income workers, middle-income workers are much less likely to have access to public protection.

Mothers' work and child care

In “Mothers' Work and Child Care,” Julia B. Isaacs, director of the Division of Data and Technical Analysis of the Department of Health and Human Services (HHS) Office of Planning, She describes the strengths and weakness of the child care data in the main national surveys. Isaacs also examines the main data sources that HHS uses to measure the availability and quality of child care for low-income families: the Current Population Survey (CPS); the Survey of Income and Program Participation (SIPP); the National Household Education Survey (NHES); the National Survey of America's Families (NSAF); state administrative data collected by the federal government that include aggregate numbers of children receiving subsidies as well as some of the characteristics of those subsidies, such as type of provider and age of child; and state studies of those who have left the welfare rolls (leaver studies).

Parental Reports of Adolescent Well-Being

We analyze data from the 1999 wave of the National Survey of America's Families (NSAF) to compare parental reports of the psychological well-being and attitudes toward school of 12- to 17-year-old adolescents residing with a cohabiting versus a remarried mother (maternal stepfamilies), and those residing with a cohabiting versus a remarried father (paternal stepfamilies). In maternal stepfamilies, cohabiting stepfathers report more positive adolescent attitudes toward school than do remarried mothers, cohabiting mothers, and remarried stepfathers. No differences in parental reports of adolescent psychological well-being or attitudes toward school are found in paternal cohabiting and married stepfamilies. Instead, in both cohabiting and married stepfamilies, the well-being of the parent is important in predicting his/her report of the psychological well-being of adolescents, and parental reports of problems with the adolescent and the adolescent's participation in extracurricular activities predict both adolescent psychological well-being and attitudes toward school. Adolescents in cohabiting and married stepfamilies are not affected differentially by the Most Knowledgeable Adult's (MKA) well-being, problems with the adolescent, and participation in extracurricular activities.

Child care, disability, and family structure: Use and quality in a population-based sample of low-income preschool children

The National Survey of America's Families (NSAF) was analyzed to examine the use and quality of child care of low-income preschool children with disabilities as contrasted to low-income nondisabled children. Family structure is a stronger predictor of child care use than disability status. Disabled and nondisabled children living with single parents show similarly elevated rates of participation in child care. Important differences were found in the use and quality of child care. Our findings related to the extremely low cost of care for disabled children living with single parents may suggest particularly deleterious developmental outcomes for these children. These findings suggest the need for child care subsidies directed at low-income disabled children and their families. Further, the protective enforcement of minimum standards of care may require further analysis.

Child Care Subsidies, Wages, and Employment of Single Mothers

This paper provides a comprehensive analysis of employment and child care payment decisions of single mothers in the early post-welfare reform environment, using data from the National Survey of America's Families (NSAF). I develop and estimate a model that examines the effects of the price of child care and the wage rate on employment decision as well as the decision to use paid child care among single mothers. The model distinguishes between the full-time and part-time employment decisions as well as the prevailing wages in these two employment markets. A semi-parametric random effects estimator and the Gaussian Quadrature are used together to estimate the system of equations for the discrete outcomes of full-time and part-time employment, and child care payment, and the linear equations of the price of child care, and part-time and full-time wages in a unified framework. The econometric model also controls for the endogeneity of child care subsidy receipt and adjusts the hourly price of child care for the amount of subsidy for mothers who receive one. The results show that full-time working mothers are more sensitive to the price of child care than part-time working mothers. A lower price of child care leads to increases in overall employment and the use of paid child care. However, much of the increase in employment is in the form of full-time employment. An increase in the full-time wage rate leads to increases in overall employment and the use of paid child care. The effects of full-time wage rate are estimated to be much larger than those of the price of child care. Part-time wage effects are found to be so small to have significant implications.

Access and Use by Children on Medicaid: Does State Matter?

Although Medicaid is a central component of health care for children, the program is not uniform across the states. Using state and nationally representative data from the 1997 National Survey of America's Families (NSAF), a survey of the economic, health and social characteristics of children, nonaged adults and their families, we examine differences in access and use by children on Medicaid across 13 states, and compare those differences to national estimates. We find significant differences in access and use across the states for children on Medicaid. The characteristics of the children and their local health care environment explain some, but not all, of the state differences in access and use.