Medicaid- and Children’s Health Insurance Program (CHIP)-enrolled children tend to live in neighborhoods with higher environmental risks, less access to health services, higher rent burden, and lower food access.

The Issue

Historic and ongoing systematic racism and economic segregation leads to children primarily covered by Medicaid and CHIP living in neighborhoods with fewer resources and amenities than children with private health insurance, perpetuating health inequities.

Key Findings

• Overall, researchers found 34.3 percent of children relied on Medicaid/CHIP at a given point in time between 2015 and 2019.
  
• Children covered by Medicaid/CHIP are highly concentrated in geographic areas.
  
  • The quintile of U.S. Census tracts with the highest prevalence of children covered by Medicaid/CHIP are home to more than 40 percent of children covered by the programs. Nearly 70 percent of enrollees live in the two quintiles with the highest prevalence of children relying on Medicaid/CHIP.
    
• Geographic areas with a higher proportion of children with Medicaid/CHIP coverage tend to have higher rent burden; less reliable food access; a lack of access to primary care, dental, or mental health providers; and higher environmental risks including air pollution, concentration of diesel particulate matter, and EPA-listed Toxic Release Inventory sites.
  

Conclusion

Neighborhood conditions have an important impact on health outcomes. Analyzing the neighborhood conditions where Medicaid- and CHIP-enrolled children live can help tailor approaches to advance equity.

About the Author/Grantee

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research. 

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