Determinants of Household Insurance Coverage Among Low-Income Families from Boston, Chicago, and San Antonio: Evidence from the Three-City Study


  • *Direct correspondence to Ronald Angel, Department of Sociology, The University of Texas, 1 University Station A1700, Austin, TX 78712 〈〉. Sonia Frias will share all data and coding information with those wishing to replicate the study.


Objectives. In this article we examine correlates of health insurance coverage for low-income households.

Methods. Using data from the Welfare, Children, and Families Project (1999–2001), a sample of 2,402 low-income families from Boston, Chicago, and San Antonio, we estimate two logistic regressions, one that predicts health insurance coverage for one focal child in each household and another that assesses the odds that all children in the household have coverage.

Results. The children of poorly-educated, immigrant, and Mexican-origin parents are at an elevated risk of lacking insurance. These characteristics also increase the risk of incomplete household coverage. Mexican-origin children and households are at particularly high risk of lacking complete coverage, a fact partially reflecting their residential concentration in states with high uninsurance rates, such as Texas.

Conclusions. Serious holes in the health-care safety net affect poor Americans differently based on their state of residence, race, ethnicity, and household structure.