Bridging Disciplinary Boundaries (January 11 - 14, 2007)

The absolute income measure of poverty currently used by the U.S. government is considered problematic by researchers and advocates because, among other things, of its failure to accurately represent actual living costs. In this paper, we examine material hardship among families raising children with disabilities, who typically experience elevated costs associated with their children's impairments; costs that are not acknowledged or addressed by the federal poverty level. Methods: Data were drawn from the 2002 National Survey of America's Families (>42,000 households). The present study sample includes 3,470 disabled and 30,862 nondisabled children. Outcome measures of material hardship included food insecurity, loss of telephone service, need to move in with others, inability to pay rent, having no health insurance, and having postponed medical or dental care. A binary measure of severe deprivation was computed from the sum of these 11, with families having 4 or more indicators determined to have experienced severe deprivation. Multivariate logistic regression models, controlling child age and maternal age, education, race and family structure, were estimated for the sample as a whole. Analyses were also conducted with children stratified by their family's income relative to the federal poverty level (<100% FPL, 100-199% FPL, or 200+ % FPL). SUDAAN was used for all analyses because it correctly estimates variance with multistage sampling designs such as the NSAF.

Results:

We report our results as predicted probabilities, controlling for all covariates, for ease of interpretation. Across the total sample of children, disabled children were much more likely to have experienced severe hardship than nondisabled children (31% and 20%, respectively). However, this pattern was consistent even when the sample was stratified by family income. Not surprisingly, families with and without disabled children whose income fell below the federal poverty level had a greater likelihood of experiencing severe hardship. Among children living below the FPL, the predicted probability of a disabled child experiencing severe hardship was 54%, significantly higher than the 45% rate for nondisabled children. Among low-income children, or those who lived in households with 100-199% of the FPL, disabled children had a 53% probability of experiencing severe hardship, as contrasted with the 32% probability of nondisabled children. Among disabled children living in households with income at or above twice the poverty threshold, there was a 16% likelihood of having experienced severe hardship, significantly higher than the 10% probability of nondisabled children at the same income level.

Implications:

Existing research suggests that children with disabilities who live with material hardship appear to be at increased risk of adverse developmental, educational, social and health outcomes. These results suggest the FPL is not a good indicator of actual material hardship among families raising children with disabilities. Strikingly high rates of severe hardship were found among disabled children who were ‘near poor.' As such, policymakers and advocates interested in the well-being of these children are advised by the present findings that expansions of current policies (e.g., Medicaid, SSI) that diminish financial hardship for families raising disabled children appear warranted.