Disparities in healthcare access

Research shows that many people face barriers that make it difficult to obtain basic health care services. Access to health care is closely tied to the ability to pay for such care. Therefore, people who are not covered by health plans, are unemployed, or are disabled, have only limited access to health care. According to previous National Healthcare Disparities Reports (NHDR), racial and ethnic minorities and people of low socioeconomic status are among those with health care access problems. In addition, findings from the NHDR showed that health insurance status was the most significant contributing factor to poor quality of care. Uninsured people, for example, were less likely to get recommended care for disease prevention such as cancer screening, flu vaccination, and dental care, or long-term disease management such as diabetes care.

In the most recent NHDR ($2013$‍), the variable “uninsurance” was explored. Researchers postulated that prolonged periods of uninsurance can have a particularly serious impact on a person’s health and stability. Some findings based on data from the Medical Expenditure Panel Survey are presented below. Figure $1$‍ shows the percentage of people under age $65$‍ who were uninsured all year, grouped by income levels. Those who had income that was less than $124\mathrm{\%}$‍ of the poverty line were considered to be in the poor category, $125$‍-$199\mathrm{\%}$‍ of the poverty line were considered low income, $200$‍-$399\mathrm{\%}$‍ middle income, and over 400% high income.

Figure 1: People under age 65 who were uninsured all year, by income, 2002-2011 Note: The sample sizes for each respective year $2002$‍-$2011$‍ were: $\mathrm{33,094}$‍, $\mathrm{28,970}$‍, $\mathrm{28,990}$‍, $\mathrm{28,617}$‍, $\mathrm{28,660}$‍, $\mathrm{25,819}$‍, $\mathrm{27,859}$‍, $\mathrm{31,036}$‍, $\mathrm{27,508}$‍, $\mathrm{29,566}$‍. All changes were statistically significant.

To further consider health care disparities among various social and socioeconomic groups, Figure $2$‍ shows the predicted percentages of adults ages $18$‍-$64$‍ who were uninsured all year, grouped by race, age, gender, family income, and education.

Figure 2: Predicted percentages of adults ages 18-64 who were uninsured all year, by race, age, gender, family income, and education, 2002-2010 Key: AI/AN=American Indian or Alaska Native; NHOPI=Native Hawaiian or Pacific Islander Note: Medical Expenditure Panel Survey, pooled $2002$‍-$2010$‍ Full Year files. Predicted percentages are predicted marginals from a logistic regression model that includes the covariates race, age, sex, family income, and education. Predicted percentages for multiple race did not meet criteria for data reliability and are not reported.

Data adapted from: Source: Adapted from the Healthcare Disparities Report (NHDR) 2013.