Tipping the Scales: Can CHIP and Medicaid Expansions Trim Obesity Rates Among Lower Income Children and Adolescents?

Problem Studied: The numbers of overweight people in the United States have more than doubled since the 1980's. According to the National Health and Nutrition Examination Survey (NHANES), the percentage of overweight and obese Americans between the ages of 20 and 74 has increased from 15% of the population in 1980 to 32.9% of the population in 2004. This trend seems to hold true for children and adolescents, as well. In 2004, 17.1% of U.S. children and adolescents were overweight (Ogden, et al., 2004). Among these, Hispanic children and adolescents had the highest rates of being overweight. According to a recent study 38.2% of Hispanic children and adolescent aged 2 to 19 are overweight or obese (Ogden, et.al. 2010). Compared to their normal weight counterparts, overweight or obese children and adolescents have higher risks for developing high blood pressure, sleep apnea, and type 2 diabetes in addition to psychological problems associated with alienation, eating disorders, mental health problems, and discrimination. These conditions can be expensive to treat and manage. However, perhaps the most important consequence of childhood obesity is that children do not simply outgrow the weight, and they are more likely to grow up to be overweight adults if the weight problem is not addressed at a younger age. Researchers have been studying causes and consequences of overweight and obesity during childhood and adulthood as well as ways to alter or improve childhood overweight trends in the U.S. It is possible that greater access to health care, including health insurance coverage and access to a usual source of care (i.e. periodic well child visits) can improve this problem. However, to date, research in the possible causal relationship between health insurance status and the use of a usual source of care and childhood overweight is limited. Results: Based on the results from previous studies, we divided our study population into three different age groups (2-6 yrs., 7-11 yrs., and 12-17 yrs.) and estimated the effects for each age group separately. The overall results indicate that USC and health insurance coverage was not endogenous in the overweight and obesity outcomes of lower income children and adolescents. Our LPM and probit results showed that CHIP eligibility significantly reduced the overweight and obesity probabilities of 2-6 year old Hispanic children, excepting those at the lowest income levels. In contrast to the results for the youngest age group, we did not see a significant reduction in overweight or obesity probabilities of lower income 7-11 year old children or adolescents. Although among adolescents CHIP eligibility had no significant effects on overweight and obesity outcomes, the LPM results indicate that CHIP eligibility significantly increased the health insurance coverage for non-Hispanic adolescents