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1.  The Impact of Gaps in Health Insurance Coverage on Immunization Status for Young Children 
Health Services Research  2008;43(5 Pt 1):1619-1636.
Objective
To examine the impact of full-year versus intermittent public and private health insurance coverage on the immunization status of children aged 19–35 months.
Data Source
2001 State and Local Area Integrated Telephone Survey's National Survey of Children with Special Health Care Needs (NS-CSHCN) and the 2000–2002 National Immunization Survey (NIS).
Study Design
Linked health insurance data from 2001 NS-CSHCN with verified immunization status from the 2000–2002 NIS for a nationally representative sample of 8,861 nonspecial health care needs children. Estimated adjusted rates of up-to-date (UTD) immunization status using multivariate logistic regressions for seven recommended immunizations and three series.
Principal Findings
Children with public full-year coverage were significantly more likely to be UTD for two series of recommended vaccines, (4:3:1:3) and (4:3:1:3:3), compared with children with private full-year coverage. For three out of 10 immunizations and series tested, children with private part-year coverage were significantly less likely to be UTD than children with private full-year coverage.
Conclusions
Our findings raise concerns about access to needed immunizations for children with gaps in private health insurance coverage and challenge the prevailing belief that private health insurance represents the gold standard with regard to UTD status for young children.
doi:10.1111/j.1475-6773.2008.00864.x
PMCID: PMC2653891  PMID: 18522671
Immunization; vaccine; health care access
2.  Assessing a multilevel model of young children’s oral health with national survey data 
Objectives
To empirically test a multilevel conceptual model of children’s oral health incorporating 22 domains of children’s oral health across four levels: child, family, neighborhood and state.
Data source
The 2003 National Survey of Children’s Health, a module of the State and Local Area Integrated Telephone Survey conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics, is a nationally representative telephone survey of caregivers of children.
Study design
We examined child-, family-, neighborhood-, and state-level factors influencing parent’s report of children’s oral health using a multilevel logistic regression model, estimated for 26 736 children ages 1–5 years.
Principal findings
Factors operating at all four levels were associated with the likelihood that parents rated their children’s oral health as fair or poor, although most significant correlates are represented at the child or family level. Of 22 domains identified in our conceptual model, 15 domains contained factors significantly associated with young children’s oral health. At the state level, access to fluoridated water was significantly associated with favorable oral health for children.
Conclusions
Our results suggest that efforts to understand or improve children’s oral health should consider a multilevel approach that goes beyond solely child-level factors.
doi:10.1111/j.1600-0528.2010.00536.x
PMCID: PMC3025295  PMID: 20370808
children’s oral health; multilevel modeling; multiple imputation

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