Children in Temporary Assistance for Needy Families (TANF) Child-Only Cases with Relative Caregivers. 3.3.3 Analysis

06/01/2004

Demographics

Race and age distribution varied substantially among the groups (Table 3-11). Only in the TANFCOR group were a majority of children Black. The majority of children in all other groups were white, although the proportions varied substantially among the groups. The majority of children in each group were aged 5 years or older, and TANFCOR children were least likely of all groups to be under 1 year of age. In the SIPP data, the TANFCOR group is an older group relative to the comparison groups. The TANFCOR group in the NSCAW data was younger relative to the comparison groups. This difference is fortuitous and convenient for examining the well-being of TANFCOR children at older ages, although the SIPP and NSCAW samples do have other underlying differences.

Table 3-11.
Demographics(a,b)
Question Response TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Child's race White 44.4 51.7 45.4* 92.6*** 64.2*** 81.2***
Black 55.2 39.7 42.7 3.4 32.2 13.9
American Indian 1.9 1.5 3.6 0.0 1.5 1.6
Asian or Pacific Islander 1.5 7.1 8.2 4.0 2.1 3.3
Mean age 9.2 7.2 8.0 9.3 9.5 8.4
Age as of last birthday Less than 1 year 1.0 9.1*** 5.3*** 7.2 5.2 6.4**
1-5 23.6 31.2 32.1 20.9 20.9 27.7
6-10 33.9 27.9 28.5 31.5 28.4 28.3
11-17 41.4 31.7 34.2 40.4 45.5 37.6
Relationship of child to reference person Child of reference person 0.0 81.3*** 89.5*** 94.2*** 0.0*** 93.6***
Grandchild of reference person 56.7 15.8 6.6 0.0 37.4 4.1
Brother/sister of reference person 10.1 0.0 4.1 0.1 0.0 0.3
Other relative of reference person 39.9 0.8 2.2 0.3 27.5 1.1
Foster child of reference person 0.0 0.0 0.0 0.0 12.4 0.0
Other 8.5 2.2 1.8 5.5 21.8 1.2
Relationship of reference person to child Biological parent 4.2 78.7 86.8 89.9 18.0 89.2
Stepparent or adoptive parent 1.8 2.5 2.0 8.8 3.7 5.3
Grandparent 68.3 13.2 5.9 1.0 45.6 3.4
Other 26.4 5.8 5.3 0.4 32.4 2.1
Total number of persons in this household in this month 1-2 7.1 5.8 8.1 5.7*** 10.6*** 4.1***
3-4 33.6 36.5 41.7 80.8 47.9 53.8
5 or more 59.4 57.8 50.4 13.5 41.3 42.2
Number of own children under 18 in family (question is asked of the household reference person) 0 70.8 12.3 4.4 19.1 85.5 6.5
1 14.9 17.1 18.2 43.0 8.2 22.3
2 4.9 22.1 25.7 28.4 4.5 37.8
3 or more 9.4 48.7 51.8 9.5 1.9 33.4
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.
(b): Data from the Survey of Income and Program Participation, a national household survey.

The relationships between the child and the reference person (the sampled household member) varied widely across the groups of children. By definition, TANFCOR households were more likely to have a nonparental relative of the child living in the household. A small majority of TANFCOR children lived with their grandparents, though many TANFCOP and KINCARE children also lived with grandparents. Almost a third of TANFCOR children lived with a relative other than their grandparent or sibling, a higher percentage than for any other group.

About 60 percent of TANFCOR households contained more than four people; other groups were more likely to contain four people or fewer. Most reference persons were likely to have up to four of their own children in the household. TANFCOR and KINCARE reference persons were least likely to have any of their own children who were under the age of 18, which makes sense given that the majority of these reference persons are grandparents.

Program Coverage

Children in TANF child-only cases with relative caregivers have lower participation in most assistance programs, and more favorable indicators of housing adequacy and food security.

Table 3-12 shows that TANFCOR households were more likely than other groups to receive SSI and General Assistance, although these distinctions are not statistically significant for most groups. However, a mixed pattern was seen for Medicaid, WIC, and Food Stamp coverage, where TANFCOR children were less likely to receive coverage than TANFCOP or TANFHH children, but more likely to be in households with this coverage than KINCARE children. The low rate of Medicaid coverage among KINCARE children is explained in some small part by their higher rate of other health insurance coverage. The fact that biological parents appear to be receiving more coverage for their household, whether from WIC, Food Stamps, or Medicaid, may indicate greater ability, desire, or assistance in navigating the system as compared with other caregivers. In the case of food stamps, relative caregiver households may be ineligible if they exceed the income limits. Given these differences in levels of public assistance, it is surprising that there are not greater differences in child outcomes. SIPP data for receipt of WIC by children alone do not alter this pattern.

Economic Well-Being

The child well-being measures in the SIPP data are complementary to those presented in NSCAW data, in a sense, because they focus more on the child's environment and experiences than on standardized testing and well-being measures. Unfortunately, the differences in measures and samples make comparisons difficult. In the SIPP data, staff focused on housing and food security as measures of economic well-being, at least at the level of the household.

The majority of each group was at least somewhat satisfied with the quality of their homes (Table 3-13). A common pattern across characteristics of their living situation is that TANFCOR families were more likely to be very or somewhat satisfied than TANFCOP and TANFHH families. Although this finding is a positive one, indicating that TANFCOR families are certainly no worse off than other TANF families, the standard of somewhat satisfied is probably a low one. Also, the differences between the families on TANF and the other groups, including KINCARE, LOWINC, and OTHER, are consistent. The non-TANF families had very high ratings of satisfaction with their housing.

Table 3-12.
Percent Reporting Service Use(a)
Question TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Federal SSI 4.4 3.0 3.6 0.0*** 3.1 1.1*
General Assistance 2.7 1.4 0.7 0.0 1.0 0.2
Foster Care Payment 0.0 0.0* 0.0* 0.0* 3.3*** 0.0*
WIC Coverage 12.1 23.0*** 14.5 0.0*** 4.0** 6.0**
Food Stamp 45.6 83.6*** 88.6*** 0.0*** 9.7*** 6.5***
Medicaid 70.3 87.0*** 89.8*** 0.0*** 28.3*** 11.7***
Health Insurance 8.2 8.8 8.0 93.1*** 38.3*** 72.4***
WIC 1.4 0.6 0.7 0.0 0.9 0.4
SSI 0.8 1.1 1.4 0.0 0.7 0.4
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

While both KINCARE and TANFCOR families are caring for relative children, Table 3-10 shows that TANFCOR households are larger and more likely to be headed by grandparents rather than other relatives. A small percentage of KINCARE families are receiving foster care payments, and may be more likely to be wage-earners. Age, household size, and access to other resources are likely to explain the different levels of satisfaction with housing. To further understand the impact of resources for relative caregivers would require more than a descriptive analysis of the data, since discerning the type of caregiver and caregiver resources is necessary.

Table 3-13.
Child's Home and Environment(a)
Question TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Percent very or somewhat satisfied with:
The general state of repair of home 77.5 73.5 74.3 96.9*** 87.0*** 90.5***
The amount of room or space in home 87.5 6.5*** 75.5*** 98.0*** 86.0 84.6
The warmth of home in winter 80.0 76.3** 73.9*** 96.8*** 86.5 89.5***
Percent who consider neighborhood very safe or safe from crime 77.7 71.1 69.0* 100.0*** 84.7*** 90.7***
Household has:
Personal computer in working condition 26.1 12.1*** 15.0** 88.3*** 34.1 54.5***
Safety devices, alarm system 11.2 10.8 9.5 54.6*** 22.7*** 28.1***
Phone in home 83.6 79.3 79.8 99.1*** 95.5*** 95.9***
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

In addition to housing satisfaction, another important dimension of economic well-being is food security. Table 3-14 shows that a large number of respondents thought issues of food security were not applicable to them, which is a positive finding in itself. The pattern of findings for food security is very similar to that of satisfaction with housing. Again, compared to others on TANF, TANFCOR children had less of a problem having enough to eat. Children in families receiving TANF (TANFHH) were the most likely to have problems with food security, and reported trouble with affording balanced meals, or having enough food for the children to eat. Even in this group, only 6.4 percent of children were reported by a caregiver as often not eating enough. The standard of "enough" is probably quite variable, but consistent with previous research; this finding indicates that the population that is most likely to have food security problems is also the most likely to be covered by WIC and food stamps.

Table 3-14.
Child's Nutrition(a)
Question Response(%) TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Couldn't afford balanced meals Often true 4.8 4.8 10.2*** 3.9*** 3.8 2.2***
Sometimes true 21.1 31.9 32.7 1.9 18.6 10.2
Never true 74.2 63.4 57.1 94.3 77.6 87.6
Children were not eating enough N/A 60.5 50.8 46.1** 94.2*** 71.3** 81.6***
Often true 2.6 1.3 6.4 0.0 1.4 1.0
Sometimes true 8.2 19.4 14.4 1.0 7.8 4.6
Never true 28.7 28.4 33.2 4.8 19.5 12.8
Didn't eat for a whole day N/A 78.2 70.4 67.3** 96.8*** 83.4 90.4***
Yes 2.7 6.2 7.6 0.0 2.3 1.5
Did get breakfast under federal school breakfast program? N/A 63.5 51.9** 51.0*** 94.7*** 74.9** 86.3***
Y 34.9 44.6 43.4 2.7 24.1 12.3
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

As compared with KINCARE, LOWINC, and OTHER children, the TANFCOR group had significantly more issues with food security. This is not surprising, except in the case of children in the KINCARE group. The discussion here parallels that of housing differences. Whether these differences reflect access to public resources, since KINCARE and TANFCOR children lived in households that were less likely to be covered by WIC and Food Stamps, is an important question.

Table 3-15 shows education and caregiver aspirations for their children as another component of child well-being. Small percentages of children in all groups attend a special class for gifted students or do advanced work in any subject. Of those groups, however, TANFCOR children were the least likely to do advanced work and most likely to have been held back, although these differences are not significant. While these characteristics may be due to trauma of separation from parents, it is surprising that there is a large difference between TANFCOR and KINCARE children in these responses. Obviously, some attention to age patterns within comparison categories would be helpful in sorting out these differences. On the surface, TANFCOR children are older as a group, and as such would be more likely to have had the chance to do advanced work, but they would also have had more of a chance to have been held back in school. More detail or multivariate analysis including age would be helpful.

Table 3-15.
Child's Education(a)
Question Response(%) TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Does child go to a special class for gifted students, or do advanced work in any subject? Yes 5.4 7.8 7.1 24.7 8.7 11.5
How far do you think child will go in school? Graduate from high school or more 95.2 97.4 96.9 89.8 89.2 87.4
Educational attainment you would like for your child Graduate from high school or continue further 95.1 98.7 98.5 91.7 90.4 98.0
Has child been held back in school? Yes 16.3 6.8 9.0 4.9 8.5 5.6
Are there family rules about how early or late child may watch television? Yes 70.8 61.0 71.0 60.3 67.3 69.3
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

The patterns for the other groups are somewhat surprising. Although the LOWINC and KINCARE groups had higher percentages of children in advanced classes and fewer being held back, they were less likely to expect or hope that their child would graduate from high school. It is worth noting that these differences are not statistically significant, and that at least 90 percent of all caregivers reported thinking and hoping that their child will complete high school or more.

Another SIPP question assesses whether the caregiver thinks their child is difficult to care for. Table 3-16 shows that caregivers reported that this is not the case for more than 98 percent of children in all categories. While children in the TANFCOR category were the most likely to be called difficult by a caregiver, the difference is small and not statistically significant.

Table 3-16.
Child's Health and Health Care Utilization(a)
Question TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
% reporting child is not hard to care for 98.1 99.8 99.7 99.1 99.4 99.8
% with private health insurance coverage in this month 8.2 9.5 8.8 97.5*** 42.2*** 74.5***
% Reporting excellent/very good/good current health status 91.7 92.9 95.1 99.3 95.4 97.8
% Reporting fair/poor current health status 8.3 7.1 5.0 0.7 4.6 2.3
% reporting no dental visits in past 12 months 58.3 61.0 53.7 22.9*** 44.5*** 43.9***
% reporting no medical provider visits, past 12 months 37.1 40.8 32.3 22.6*** 34.5 30.8
% reporting more than 2 sick days in past 12 months 3.6 2.5 4.3 14.4 6.2 6.3
% who did not see a dentist when needed 8.6 11.6 12.0 1.2*** 12.4 2.5
% who did not see a doctor when needed 11.6 10.1 14.8 3.6** 9.6 7.5
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

Another dimension of child well-being that is more comparable to data from NSCAW relates to child health and health care utilization. Differences in health status are not very large: across all categories of children, more than 90 percent were reported to be in good, very good, or excellent health. TANFCOR and TANFCOP children were the most likely to report being in fair or poor health, with KINCARE and TANFHH children being in the middle, and LOWINC and OTHER children being in the best health. Although these differences are not statistically significant, the pattern reflects a consistent one, with TANF children doing worse than their nonTANF counterparts, including the KINCARE group. Across all groups, KINCARE, LOWINC, and OTHER had high rates of private insurance coverage for the current month, which likely reflects higher income or caregiver employment, and lower Medicaid eligibility in these groups.

Measures of well-being suggest that children in TANF child-only cases with relative caregivers fare better than other children on TANF, but not as well as children in kinship care.

In terms of health care utilization measures, again the pattern is consistent, but less dramatic. The LOWINC group was more likely to have seen a doctor and a dentist in the past year, consistent with higher reports of sick days. The other non-TANF groups, KINCARE and OTHER, were also more likely to have seen a dentist. This may reflect a lack of dental coverage or limited access to dentists in the state Medicaid programs, since TANF children are more likely to have Medicaid coverage. Differences for dental care are statistically significant, while only the LOWINC group is statistically more likely to have seen a doctor in the past year. The other groups were all similar, with about 60 to 65 percent reporting at least a medical visit in the past year, and small numbers reporting more than one sick day in the past year.

Not surprisingly, LOWINC members were also least likely to report not having received medical or dental care when they needed it. The TANF children had higher rates of unmet need for medical and dental coverage, ranging from 9 to 15 percent. Among TANF children, TANFHH were the most likely to report unmet need, although the difference is not statistically significant. It is interesting to note that in terms of unmet need, the KINCARE group had rates as high as the TANF groups. Given the private insurance coverage in the KINCARE group, this finding might indicate more of a problem with caregiver access than with coverage, but nothing can be concluded from these descriptive results.

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