Unmarried births and health-care costs

Unmarried childbearing and health-care costs Q:You recently wrote about health-care inequities. Why didn't you include, for instance, that the reason people in the Richmond area don't have money to pay for health care is the (high) illegitimacy rate. The fathers aren't around. They could be buying health insurance for the babies they father.

Answer: You are not the first to raise concerns about the social costs of unmarried births, but the reasons people don't have health insurance are more complex.

The lowest income children probably do have health insurance. For lowto moderate-income children, health insurance is provided through government-funded programs such as Medicaid and the state children's health-insurance program.

Surveys suggest that many of the uninsured are working. A 2008 Virginia Health Care Foundation survey found that among the 1 million Virginians without health insurance, 74 percent live in households where at least one person works full time, and 9.2 percent live with a person who works part time.

What the working uninsured often experience is their employer does not offer health insurance or it's not affordable. A report out this week from the Kaiser Family Foundation and the Health Research and Education Trust showed the average health-insurance premium for a family in 2009 is $13,375. For people insured through their jobs, the employer usually picks up, on average, $9,860 of that. The worker contributes about $3,500 toward the total costs.

Richmond does have a high percentage of unmarried births -- estimated at 62 percent. It's not the highest rate in the state. In the U.S., unmarried births account for 39 percent of births. Experts have examined whether unmarried childbearing causes poverty and vice versa, whether poverty causes unmarried childbearing.

A June 2008 report by The Community Foundation looking at the impact of unmarried childbearing in the Richmond area singles out the work of Princeton University's Fragile Families and Child Wellbeing Study.

One report based on data collected for the project concluded that "preparing parents for jobs and increasing their work hours -- whether they marry or not -- is an essential ingredient to poverty reduction."

On the other hand, you have the pro-marriage Heritage Foundation noting that "over 80 percent of long-term child poverty occurs in broken or never-married families."

The Richmond Health District has a multidisciplinary effort focusing on male responsibility. "We want to reduce out-of-wedlock pregnancy by 25 percent by 2012, to reduce male dropouts by 25 percent by 2012, and increase two-parent families . . . by 25 percent in 2012," said Brian Gullins, the health district's male responsibility coordinator.

Contact Tammie Smith at (804) 649-6572 or .