Pennsylvania uninsured likely to be sick but not seek care

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The cost of health insurance coverage in Southeastern Pennsylvania keeps millions without health coverage who are likely to be sick and not seek screening due to the high cost.

By Nikki Reen

PHILADELPHIA - As the Supreme Court considers the constitutionality of the Patient Protection and Affordable Care Act (ACA), health care reform and the future of the law have come to the forefront of national conversations. The passage of the ACA in March 2010 and the subsequent debate of the law have increased the visibility of the growing uninsured population in this country. According to The Commonwealth Biennial Health Insurance Survey of 2010, an estimated 52 million adults between the ages of 19 and 64 were uninsured at some point in 2010, compared with 38 million in 2001.* This represents nearly 30% of all adults in this age group in 2010.**

Through data from the Community Health Data Base’s 2010 Southeastern Pennsylvania Household Health Survey, researchers examined demographic and socio-economic characteristics of adults ages 18-64 who are uninsured and also looked at the health disparities between insured and uninsured adults in this age group.

Adults in Southeastern Pennsylvania who identified as being uninsured named several reasons for their lack of health insurance. The top three reasons in the 2010 Survey were: costs (37.2%), change of employer (18.4%), or being unemployed/not working (13.0%). Women are more likely to state “unemployment/not working” as a reason for being uninsured (23.9%) compared with men (14.5%).

“There are clear demographic and socio-economic differences between uninsured and insured adults between the ages of 18 and 64 in the region,” says CHDB researcher Sarah Ingerman. “Uninsured adults are more likely to be younger, live in urban areas, identify as Latino, live below 150% of the Federal Poverty Line, not have a high school degree or GED, and be unemployed.”

An Overview of the Uninsured

In Southeastern Pennsylvania, 11.4% of adults between the ages of 18 and 64 are uninsured. This represents an estimated 276,400 adults who are uninsured in the region. The Survey showed the following:

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* Adults residing in urban areas are nearly two times as likely to be uninsured (16.1%) compared with adults in suburban counties (8.4%).
* As age increases, the percentage of adults who are uninsured decreases. Young adults, specifically those between the ages of 18 and 29, are more likely to be uninsured (20.8%) than adults ages 30-39 (12.7%), 40-49 (9.3%), and 50-64 (6.8%).
* Latino adults are the most likely racial/ethnic group to be uninsured (31.6%), followed by Black adults (16.6%), Asian adults (14.1%) and white adults (7.5%).
* Adults living below 150% of the Federal Poverty Line (FPL) are nearly three times more likely to be uninsured (24.3%) compared with those living at or above 150% of the FPL (8.5%).
* Adults with less than a high school degree/GED are the most likely to be uninsured (29.1%) and as educational attainment increases, the percentage of adults who are uninsured decreases.
* Adults who identify as being unemployed are the most likely to be uninsured; one third of adults who are unemployed are also without health insurance (33.7%).

Health Disparities of Uninsured Adults

Living without health insurance can have serious health implications. The Household Health Survey data show existing health disparities between uninsured and insured adults, especially in terms of health status, having a regular source of care, receiving select preventive screenings, and experiencing cost barriers to care.

* Uninsured adults are more likely to be in fair or poor health (19.9%) compared with insured adults (13.9%).
* Uninsured adults are about four times as likely not to have a regular source of care (37.1%) compared with insured adults (8.3%).
* Women who are uninsured are significantly more likely notto have had a Pap test (59.6%), a clinical breast exam (58.3%), and a mammogram (64.6%) in the past year compared with insured adults (30.2%, 26.6%, 32.9% respectively).
* Adults who are uninsured are more likely to be sick but not seek care due to cost (43.0%), not fill a prescription medicine due to the cost (37.5%), and not receive dental care due to the cost (57.7%).

The data show clear health disparities between insured and uninsured adults in the region. Overall, uninsured adults are more likely to be in fair or poor health, not have a regular source of health care, not have certain recommended screenings in the past year and experience a range of cost barriers to care.

For more information about these findings, please contact Nicole Dreisbach at [email protected]

*Collins S.R., Doty M.M., Robertons R., Garber T. “Help on the Horizon: Findings from The Commonwealth Fund Biennial Health Insurance Survey of 2010.” 2011. The Commonwealth Fund.

**Ibid.

About CHDB
Public Health Management Corporation’s Community Health Data Base Household Health Survey is one of the largest regional health surveys in the country. The Pew Charitable Trusts, William Penn Foundation, United Way of Southeastern Pennsylvania, United Way of North Penn, CIGNA Foundation, Green Tree Community Health Foundation, Philadelphia Foundation, North Penn Community Health Foundation, the Thomas Scattergood Foundation and over 350 local agencies from the health, government, nonprofit and academic sectors help to support CHDB. To view previous data news releases, please click here. For more information, or to access key findings from previous years please visit www.chdbdata.org.

About PHMC
Public Health Management Corporation (PHMC) is a nonprofit public health institute that creates and sustains healthier communities. PHMC uses best practices to improve community health through direct service, partnership, innovation, policy, research, technical assistance and a prepared workforce. PHMC has served the region since 1972. For more information on PHMC, visit www.phmc.org.

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