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Pamela R. Wood, MD, Lauren A. Smith, MD, MPH, Diana Romero, PhD, MA, Patrick Bradshaw, MS, Paul H. Wise, MD, MPH and Wendy Chavkin, MD, MPH

Pamela R. Wood and Patrick Bradshaw are with the Department of Pediatrics, University of Texas Health Science Center, San Antonio. Lauren A. Smith and Paul H. Wise are with the Department of Pediatrics, Boston University School of Medicine, Boston, Mass. Diana Romero and Wendy Chavkin are with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City.

Correspondence: Requests for reprints should be sent to Pamela R. Wood, MD, Department of Pediatrics, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900 (e-mail: woodp{at}uthscsa.edu).

Objectives. This study evaluated the relationships between health insurance and welfare status and the health and medical care of children with asthma.

Methods. Parents of children with asthma aged 2 to 12 years were interviewed at 6 urban clinical sites and 2 welfare offices.

Results. Children whose families had applied for but were denied welfare had more asthma symptoms than did children whose families had had no contact with the welfare system. Poorer mental health in parents was associated with more asthma symptoms and higher rates of health care use in their children. Parents of uninsured and transiently insured children identified more barriers to health care than did parents whose children were insured.

Conclusions. Children whose families have applied for welfare and children who are uninsured are at high risk medically and may require additional services to improve health outcomes.

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