In tough times, single mothers are spending more on their child's health

An economic shock—such as the loss of a job, income, wealth, or health insurance—does not affect two-parent families the same way, according to the new study.

“In particular, we were interested in whether parents sacrifice their own health care spending in favor of spending for children during such times,” says lead author Alan Monheit a professor of health economics and public policy at Rutgers School of Public Health and a research professor at the Center for State Health Policy at Rutgers Institute for Health, Health Care, and Aging.

“We sought to identify family types whose health care spending was especially vulnerable to changes in their economic status, and whether particular family members’ health care spending was at risk due to a loss in economic status.”

For the study, which appears in Review of Economics of the Household, researchers looked at total health care spending data from 8,960 families from the 2004 to 2012 in the Medical Expenditure Panel Survey (MEPS).

The findings show that both realized income losses and expectations of a decline in economic status, such as an increase in the national unemployment rate, has a significant impact on health care spending decisions of single mothers compared to two-parent families.

“Single mothers shift health spending away from themselves and to their children,” Monheit says. “This shift occurs in single families with regard to total family health care spending, and in some cases with regard to spending for ambulatory care, physician office-based care, and dental care. We find no such shifts in spending in two-parent families.”

The findings are consistent with altruistic behavior by single mothers toward their children, and speaks to the vulnerability of single-mother families compared to two-parent families.

“Our findings may reflect the constrained economic circumstances of many single-mother families, and the difficult trade-offs such families must make to maintain the welfare of their children,” Monheit says.

When families can’t afford regular health care, it can cause delayed treatment, declining health, and greater reliance on hospital emergency departments, which increases overall health care costs for society.

“Our research raises two important questions,” Monheit says.

“First, is the shift in spending in single-mother families in response to an economic shock is likely to be transitory or longer-term in nature? Second, are existing public policy interventions, such as the Affordable Care Act’s Medicaid expansion and Medicaid/CHIP programs in non-expansion states, sufficient to address the health spending consequences of an income loss by single-mother families?”