Lack of Community Insurance and Mammography Screening Rates Among Insured and Uninsured Women

2008 ◽  
Vol 26 (11) ◽  
pp. 1865-1870 ◽  
Author(s):  
José A. Pagán ◽  
David A. Asch ◽  
Cynthia J. Brown ◽  
Carmen E. Guerra ◽  
Katrina Armstrong
Keyword(s):  
Health Insurance ◽  
Mammography Screening ◽  
Negative Impact ◽  
Insurance Coverage ◽  
Local Population ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Health Insurance Status ◽  
The Past ◽  
Individual Health

Purpose To evaluate whether the proportion of the local population without health insurance coverage is related to whether women undergo mammography screening. Methods Survey data on 12,595 women 40 to 69 years of age from the 2000 to 2001 Community Tracking Study Household Survey were used to analyze the relation between community lack of insurance and whether the respondent had a mammogram within the past year. Results Women age 40 to 69 were less likely to report that they had a mammogram within the last year if they resided in communities with a relatively high uninsurance rate, even after adjusting for other factors. After adjusting for individual insurance and other factors, a 10-percentage-point decrease in the proportion of the local insured population is associated with a 17% (95% CI, 13% to 21%) decrease in the odds that a woman age 40 to 69 years will undergo mammography screening within a year. Conclusion Women living in communities with high uninsurance are substantially less likely to undergo mammography screening. These results are consistent with the view that the negative impact of uninsurance extends to everyone in the community regardless of individual health insurance status.

Why Do Hispanics Have So Little Employer-Sponsored Health Insurance?

2007 ◽  
Vol 44 (3) ◽  
pp. 257-279 ◽  
Author(s):  
James D. Reschovsky ◽  
Jack Hadley ◽  
Len Nichols
Keyword(s):  
Human Capital ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Spanish Speakers ◽  
National Data ◽  
Spanish Speaking ◽  
English Speaking ◽  
Employer Health Insurance

This paper investigates low rates of employer health insurance coverage among Hispanics using national data from the Community Tracking Study Household Survey. Interview language served as a proxy for the degree of assimilation. Findings indicate that English-speaking Hispanics are more similar to whites in their labor market experiences and coverage than they are to Spanish-speaking Hispanics. Spanish-speakers' very low human capital (including their inability to speak English) results in much less access to job-based insurance. Though less important, Spanish-speaking Hispanics' demand for employer-sponsored insurance appears lower than that of English-speaking Hispanics or whites. Results suggest that language and job training may be the most effective way to bolster Hispanics' insurance coverage.

The Incidence of Health Shocks, Formal Health Insurance, and Informal Coping Mechanisms

2016 ◽  
Vol 15 (6) ◽  
pp. 665-695
Author(s):  
Samuel Amponsah
Keyword(s):  
Developing Countries ◽  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Household Survey ◽  
Health Insurance Coverage ◽  
Coping Mechanisms ◽  
Health Shocks ◽  
Economics Of Health ◽  
The Impact

In recent years, both theoretical and empirical research has accumulated in development economics literature regarding household behavior in response to shocks in developing countries. The literature especially has explored deeply the impact of weather-related shocks—such as droughts and floods—and the efficiency of informal mechanisms to cope with these shocks. In sharp contrast, our knowledge on the economics of health shocks in low-income developing countries is rather limited. A few studies have documented that low incomes and poor health insurance coverage account for catastrophic medical expenditures in the event of a health shock. This study uses a combination of Ghanaian household survey datasets to examine the different coping mechanisms employed by uninsured households to protect themselves from the incidence of health shocks. In addition, it explores the impact of formal health insurance (the National Health Insurance Scheme) on households’ out-of-pocket spending and catastrophic health expenditures.

scholarly journals Association Between Health Insurance and Race With Mortality From Trauma: a Retrospective Study

2021 ◽  
Author(s):  
Ibrahim Gwarzo ◽  
Maria Perez-Patron ◽  
Xiaohui Xu ◽  
Tiffany Radcliff ◽  
Jennifer Horney
Keyword(s):  
Health Insurance ◽  
Trauma Registry ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Registry Data ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Trauma Mortality ◽  
Race Ethnicity ◽  
Related Mortality

Abstract Background: The population health implications of the growing burden of trauma-related mortality may be influenced by access to health insurance coverage, and demographic characteristics such as race and ethnicity. We investigated the effects of health insurance status and race/ethnicity on the risk of mortality among trauma victims in Texas.Methods: Using Texas trauma registry data from 2014 - 2016, we categorized health insurance coverage into private, public, and uninsured, and categorized patients with serious injuries into Non-Hispanic Whites, Non-Hispanic Blacks, Hispanics Any-Race, and Others. Multivariate logistic regression was used to estimate the effects of health insurance status and race/ethnicity on mortality, controlling for age, gender, severity of the trauma, cause of trauma, presence of comorbid conditions, trauma center designation, presence of a traumatic brain injury (TBI), and severity of a TBI. Results: From January 1, 2014, to December 31, 2016, there were 415,159 trauma cases in Texas; 8,827 (2.1%) were fatal. Among patients with at least a moderate injury, 24, 606 (17.4%) were uninsured, and 98, 237 (69.4%) identified as Non-Hispanic White. In the multivariate analysis, Hispanics of any race and Non-Hispanic Blacks had higher adjusted odds of trauma mortality compared to Non-Hispanic Whites [ORHispanics= 1.25: 95% CI (1.16 – 1.36)] [ORBlacks= 2.11: 95% CI (1.87 – 2.37)]. Similarly, compared to privately insured, uninsured patients had 86% higher odds of trauma-related death [OR= 1.86: 95% CI (1.66 – 2.05)]. The effects of lack of health insurance on trauma mortality varied across race/ethnicity of the victims; uninsured Non-Hispanic Blacks had disproportionately higher adjusted odds of trauma mortality than uninsured Whites. Conclusion: Using Texas trauma registry data, we found significant disparities in trauma-related mortality risk based on race/ethnicity and health insurance coverage. The identification of trauma mortality inequalities could inform the design and implementation of future public health interventions.

scholarly journals Measuring the Protective Effect of Health Insurance Coverage on Out-of-Pocket Expenditures During the COVID-19 Pandemic in the Peruvian Population

2021 ◽  
Author(s):  
Akram Hernández-Vásquez ◽  
Carlos Rojas-Roque ◽  
Antonio Barrenechea-Pulache ◽  
Guido Bendezu-Quispe
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Household Survey ◽  
Interrupted Time Series ◽  
Health Insurance Coverage ◽  
Interrupted Time Series Analysis ◽  
Cross Sectional ◽  
Treatment Groups ◽  
Quasi Experimental ◽  
National Household Survey

Background: Health insurance coverage is expected to protect individuals from out-of-pocket (OOP) expenditures, potentially preventing them from falling into poverty. However, to date, the effect of health insurance on OOP spending during the COVID-19 pandemic has not been fully explored. This study aimed to estimate differences in the proportion and the amount of OOP expenditures among Peruvians during the pre- and post-mandatory lockdown response to COVID-19 in 2020 according to the health insurance coverage status. Methods: This study utilized repeated cross-sectional data from the National Household Survey on Living and Poverty Conditions from the first quarter of 2017 until the fourth quarter of 2020. The outcomes were i) the proportion of individuals who incurred OOP expenditures and ii) the monetary value of OOP expenditures. An interrupted time series analysis (ITS) and a quasi-experimental difference-in-difference (DID) analysis were performed to examine the outcomes among the control (individuals without health insurance) and treatment groups (individuals with health insurance) after the COVID-19 pandemic. Results: ITS analysis showed that the proportion of individuals reporting OOP expenditures after implementation of mandatory lockdown due to COVID-19 in Peru decreased in both groups, but no difference in the slope trend was found (p=0.916). The average quarterly amount of OOP spending increased in both groups, but no difference in the slope trend was found (p=0.073). Lastly, the DID analysis showed that the mandatory lockdown was associated with a higher amount of OOP, but there was no evidence to indicate that the higher amount was different between the control and treatment groups. Conclusion: The mandatory lockdown in response to the COVID-19 was associated with a higher amount of OOP expenditures and a lower likelihood of incurring OOP expenditures. However, our findings suggest that health insurance coverage does not lower OOP expenditures or reduce the likelihood of incurring OOP expenditures.

scholarly journals The Impact of Macroeconomic Conditions on the Health Insurance Coverage of Americans

2003 ◽  
Vol 6 (1) ◽  
Author(s):  
John Cawley ◽  
Kosali I. Simon
Keyword(s):  
Health Insurance ◽  
Unemployment Rate ◽  
Insurance Coverage ◽  
Economic Recession ◽  
Health Insurance Coverage ◽  
Indicator Variable ◽  
Health Insurance Status ◽  
Percentage Point Increase ◽  
Nationally Representative ◽  
The Impact

In March 2001, the longest economic expansion in U.S. history ended, and an economic recession began. This paper seeks to provide a better understanding of the historical relationship between macroeconomic variables and health insurance coverage.We use data from two nationally representative samples: the Survey of Income and Program Participation (SIPP) and the National Longitudinal Survey of Youth (NLSY). The longitudinal nature of our data allows us to remove individual-specific, time-invariant heterogeneity and to focus on changes in health insurance status in response to changes in macroeconomic variables.The results confirm our prediction that the probability of any health insurance coverage is negatively associated with unemployment rate. We find that a one percentage point increase in the state unemployment rate is associated with a decrease in the probability of health insurance coverage, through any source, of 0.62 percent for men, 0.54 percent for women, and 1.1 percent for children. However, our prediction that an indicator variable for national recession would be negatively correlated with the probability of health insurance coverage is not supported by the data. We find that changes in employment status explain roughly one-quarter of the correlation between health insurance coverage and unemployment rates. Our estimates imply that 440,000 men, 436,000 women, and 494,000 children have lost health insurance coverage during the current recession.

The association between health insurance coverage disruptions and access to care and affordability among cancer survivors in the United States.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 121-121
Author(s):  
Jingxuan Zhao ◽  
Xuesong Han ◽  
Leticia Maciel Nogueira ◽  
Ahmedin Jemal ◽  
K Robin Yabroff
Keyword(s):  
Health Insurance ◽  
Cancer Survivors ◽  
Access To Care ◽  
Insurance Coverage ◽  
Preventive Services ◽  
Health Insurance Coverage ◽  
The United States ◽  
Current Health ◽  
The Past ◽  
Services Use

121 Background: Having health insurance is a strong predictor of access to care and affordability. To date, most studies evaluating the effects of insurance coverage measured it only at a single time point. Little is known about the effects of coverage disruptions. This study aims to assess associations of a health insurance coverage disruption with access and affordability among cancer survivors in the United States. Methods: We identified 6476 cancer survivors aged 18-64 years with current health insurance coverage from the 2011-2017 National Health Interview Survey. Coverage disruption was measured by the question “In the past 12 months, was there any time when you did not have any health insurance or coverage?”. Access to care and affordability was measured by: 1) preventive services use (e.g. blood pressure check); and 2) forgoing care because of cost, respectively, in the past 12 months. We used separate multivariable logistic models to evaluate the associations between a coverage disruption and healthcare access and affordability, by current health insurance coverage. Results: Among survivors with current health insurance coverage, 3.7% of those with private and 8.1% with public insurance reported a coverage disruption in the past 12 months. Among survivors with current private coverage, those with a recent coverage disruption reported lower likelihood of any preventive services use (OR = 0.1, 95% CI: 0.1-0.3) and higher likelihood of forgoing any care because of cost (OR = 6.0, 95% CI: 3.9-9.5) compared to those with continuous private coverage. Among survivors with current public coverage, those with a recent coverage disruption reported lower likelihood of any preventive services use (OR = 0.4, 95% CI: 0.2-0.9) and higher likelihood of forgoing any care because of cost (OR = 4.3, 95% CI: 2.5-7.3) compared to those with continuous public coverage. Conclusions: Currently insured cancer survivors with a recent health insurance coverage disruption were more likely to report problems in access to care and affordability compared to the continuously insured. Improving private and public insurance coverage continuity may be effective in addressing these problems.

scholarly journals Individual Health Insurance within the Family: Can Subsidies Promote Family Coverage?

2007 ◽  
Vol 44 (3) ◽  
pp. 303-320 ◽  
Author(s):  
Kanika Kapur ◽  
José J. Escarce ◽  
M. Susan Marquis
Keyword(s):  
Health Insurance ◽  
Health Plan ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Implementation Cost ◽  
Household Data ◽  
Individual Health ◽  
The Family ◽  
Family Decisions

This paper examines the role of price in health insurance coverage decisions within the family to guide policy in promoting whole family coverage. We analyze the factors that affect individual health insurance coverage among families, and explore family decisions about whom to cover and whom to leave uninsured. The analysis uses household data from California combined with abstracted individual health plan benefit and premium data. We find that premium subsidies for individual insurance would increase family coverage; however, their effect likely would be small relative to their implementation cost.

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