Effects of Family Structure on Healthcare Coverage

To assess the role of family structure on policy outcomes, Dr. Henry Potrykus and Dr. Patrick Fagan of the Marriage and Religion Research Institute developed empirical models determining the influence of explanatory variables on various outcomes across the geographic-demographic areas of the U.S. These geographic-demographic areas are the Super Public Use Microdata Areas constructed by the U.S. Census. Potrykus and Fagan conclude that family structure always has a beneficial influence on policy outcomes. Family structure is a key factor in healthcare coverage.

1. Public Health Insurance

1.1 Adults

The fraction of intact families in the geographic area has the largest attenuating influence on the fraction of 25- to 54-year-olds receiving public healthcare. The fraction of intact families has a large, attenuating, precisely determinable1) influence on public healthcare receipt among 25- to 54-year-olds, even after applying controls for demographics, education, and earnings.

The fraction of high school graduates in the geographic area has a similar influence. The fraction of college graduates in the geographic area has the next-largest attenuating influence on public healthcare recipiency among 25- to 54-year-olds when controlling only for demographics and education, but the influence is no longer determinable when controls for earnings are applied.

The fraction of Hispanics and the fraction of blacks in the geographic area's population have the next-largest attenuating influence, after controlling for demographics, education, and earnings.

Urbanicity (i.e., population density) has a modest, enhancing, but precisely determined influence on public healthcare receipt among 25- to 54-year-olds.

Income earned in prime age has an attenuating and precisely determined influence.

1.2 Minors

Public healthcare recipiency among minors is strongly attenuated by the level of familial intactness in an area.

The fraction of families intact in the geographic area is second in its attenuating influence on the fraction of minors receiving public healthcare only to the fraction of the population that completed high school. Both have precisely determinable influences when controlling for demographic, education, and economic factors.

The fraction of the population that completed college also attenuates the proportion of minors receiving public healthcare, although less than high school education and family intactness do. Moreover, this influence becomes indeterminable when income is controlled for separately.

The fraction of the population that is black has a precisely determinable, enhancing influence on minors' public health insurance recipiency. The fraction of the population that is Hispanic has no determinable influence on the fraction of minors having public health insurance.

Urbanicity has a small but precisely determinable enhancing influence on the fraction of minors receiving public healthcare.

The ratio of minors to adults has an attenuating influence on the fraction minors receiving public healthcare. Larger families, in the dominant racial-ethnic population, show attenuated dependency.2)

2. Private Healthcare

2.1 Adults

The fraction of high school drop-outs in the geographic area has the largest influence on the fraction of 25- to 54-year-olds with private healthcare coverage. The influence is negative and precisely determinable with controls for demographics, education, and earnings: High school graduation has a positive influence.

The fraction of intact families has the next-largest positive, precisely determinable influence with the same controls applied.

The fraction of college graduates has a larger positive, precisely determinable influence on private healthcare coverage for 25- to 54-year-olds, as well, but the influence's precision only persists under controls for demographics and education; when controls for earnings are added, the influence is undeterminable.

The fractions of Hispanics and blacks in the geographic area have negative but precisely determinable influences on the fraction of 25-to 54-year-olds with private healthcare coverage. The influence of blacks is more modest than that of Hispanics.

Income earned in prime age has a precisely determinable positive influence on the fraction of 25- to 54-year-olds with private healthcare coverage.

2.2 Minors

The fraction of high school drop-outs and the fraction of intact families in the geographic area have offsetting influences on the fraction of minors with private healthcare coverage. High school graduation has a larger influence than Belonging on the area's healthcare coverage levels. The influence of drop-outs and Belonging is precisely determinable with controls for demographics, education, and earnings.

The fraction of college graduates in a geographic area has a relatively small but positive and precisely determinable influence on the fraction of minors with private healthcare coverage, when controlling only for demographics and education; however, when controls for earnings are added, college graduation has a marginal, negative influence on the fraction of minors with private healthcare coverage.

The fractions of Hispanics and blacks in the geographic area's population have small, negative, but precisely determinable influences on the fraction of minors with private healthcare coverage, with controls for demographics, education, and earnings active.

Income earned in prime age has a precisely determinable influence; it has a positive influence on the fraction of minors with private healthcare coverage.

1) Precision has no formal meaning. It indicates how clearly determinable (distinguishable from zero) an influence on an outcome is. Precision is comparable to standard deviation. Low/ no precision indicates a high standard of deviation in which data points spread over a large range of value, signifying that the influence of one variable over another is relatively uncertain. High precision indicates a low standard of deviation in which data points hover around the mean, signifying that the influence of one variable over another is relatively certain. For further elaboration see “Marriage and Economic Well-Being: The Economy of the Family Rises or Falls with Marriage”
2) This interpretation is born out in additional modeling in which we study the interaction between race and ethnicity and minor dependency. Enhanced dependency occurs in Hispanic and black sub-populations when there are more children. Attenuated dependency occurs otherwise.


This entry draws heavily from U.S. Social Policy Dependence on the Family.