Health care coverage and use of preventive services among the near elderly in the United States.

Abstract

OBJECTIVES: It has been proposed that individuals aged 55 to 64 years be allowed to buy into Medicare. This group is more likely than younger adults to have marginal health status, to be separating from the workforce, to face high premiums, and to risk financial hardship from major medical illness. The present study examined prevalence of health insurance coverage by demographic characteristics and examined how lack of insurance may affect use of preventive health services. METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing telephone survey of adults conducted by the 50 states and the District of Columbia. RESULTS: Many near-elderly adults least likely to have health care coverage were Black or Hispanic, had less than a high school education and incomes less than $15,000 per year, and were unemployed or self-employed. Health insurance coverage was associated with increased use of clinical preventive services even when sex, race/ethnicity, marital status, and educational level were controlled. CONCLUSIONS: Many near-elderly individuals without insurance will probably not be able to participate in a Medicare buy-in unless it is subsidized in some way.

Use of preventive care by the working poor in the United States

“…Patient education and health insurance coverage were added last, as we were specifically interested in their potential mediating effects on the otherwise fully adjusted model, an approach that has been suggested when studying social disparities in health care use (Braveman et al, 2005;Braveman et al, 2004). Moreover, their effects were of particular interest given the known associations between use of preventive care and both education (Sambamoorthi and Mcalpine, 2003;Selvin and Brett, 2003) and health insurance coverage (Ayanian et al, 2000;Devoe et al, 2003;Powell-Griner et al, 1999;Ross et al, 2006). In addition, we tested the interaction between working poverty and both health insurance coverage and self-reported fair or poor health status in our multivariable analyses based on bivariate associations.…”

Influence of beliefs about cervical cancer etiology on pap smear use among Latina immigrants

“…Indeed, providing health insurance to the uninsured would probably be the most effective method of increasing use of preventive services. However, having a regular source of care, higher family incomes, and higher education levels also play an important role (Estrada et al 1990;Calle et al 1993;Pérez-Stable et al 1994;Schur et al 1995;Tortolero-Luna et al 1995;Hubbell et al 1996;O'Malley et al 1997;Buller et al 1998;Howe et al 1998;Powell-Griner et al 1999;Roetzheim et al 1999;Zambrana et al 1999;Wu et al 2001).…”

Impact of U.S. Citizenship status on cancer screening among immigrant women

“…7,8 Numerous barriers to cancer screening have been identified; sociodemographic and health access factors such as older age, low income or educational level, and lack of health insurance or regular source of health care have been extensively documented. 3,[9][10][11][12][13][14][15][16][17][18][19] Barriers related to culture, knowledge, and attitudes such as acculturation, fatalism, and low English proficiency also play an important role. 17,[20][21][22][23][24][25][26] Immigrants who are not U.S. citizens may be disproportionately affected by these barriers and may face additional challenges to access and receive appropriate health care as compared to immigrants who have become U.S. citizens.…”