Cutler Institute for Health and Social Policy

Population Health and Health Policy

Health Insurance Dynamics of Uninsured Rural Families

1/1/2004 - 1/31/2005
Principal Investigator: 
Andrew Coburn

Numerous studies have found higher uninsured rates among rural versus urban residents, yet our understanding of the health insurance coverage of rural families remains limited. This is because the previous studies have focused on the insurance status of rural individuals despite growing recognition among researchers and policymakers that health insurance is what the Institute of Medicine (IOM) calls "A Family Matter" (IOM 202).

To better understand the dynamics of insurance coverage among rural and urban families, this study will use the Medical Expenditure Panel Survey (MEPS) to compare family health insurance coverage among non-elderly rural and urban families. This study has three objectives: 1) In households with at least one uninsured member, to determine if there are rural-urban differences in family-level insurance status (fully insured, partially insured, or completely uninsured; 2) Among families with mixed coverage, to identify the insurance status of other family members (Medicare, Medicaid, employer-sponsored, and non-group private); and, 3) To determine what employment and socioeconomic characteristics are associated with rural families health insurance mix and whether these characteristics are the same or different than for urban families.

Given that current strategies to address the uninsured appear to be focused almost exclusively on incremental health insurance reform, the findings from this study will assist policy-makers in determining how to build on existing insurance systems in ways that will be most effective for rural families.

Start Date: 
Thu, 2004-01-01
End Date: 
Mon, 2005-01-31
Legacy Muskie ID: 

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

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