Falling Behind: Americans' Access to Medical Care Deteriorates, 2003-2007

Presents survey results on access to medical care for the insured and the uninsured, the healthy and the ill, and for children in wealthy and poor families. Discusses causes of unmet needs such as rising costs and obstacles in the health system and plans

Child Health and Access to Medical Care

This article reviews studies that explore the relationship between access to medical care and children's health. The authors find that, on the whole, policies to improve access indeed improve children's health, with the caveat that context plays a big role. Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments they offer to health care providers, or when health care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children's access to medical care

No. 07: Household Food Security and Access to Medical Care in Maputo, Mozambique

The relationship between household access to medical care and food security is a potentially circuitous and challenging relationship to model. This discussion paper uses multiple modelling techniques to determine the quality of the relationships between these variables using household survey data collected by the Hungry Cities Partnership in 2014 in Maputo, Mozambique. The results of the investigation are framed according to the Sustainable Livelihood Framework and indicate a predictive relationship between household food security status and consistent household medical care access among the sampled households. The results also identify potential conditional independence in the relationship between other demographic variables and these two dependent variables among the surveyed households

Diabetes in California: Findings From the 2001 California Health Interview Survey

Examines the prevalence of diabetes in California, with particular attention paid to disparities between different population groups. Includes access to medical care, diabetes care and management, and identifying at-risk populations

A Growing Hole in the Safety Net: Physician Charity Care Declines Again

Examines reasons for the decline in the number of physicians providing free or reduced cost health care in proportion to the number of uninsured Americans, in the last decade. Includes implications related to the decline in access to medical care

The American Pathology of Inequitable Access to Medical Care

What most defines access to health care in the United States may be its stark inequity. Daily headlines in top newspapers paint the highs and lows. Articles entitled: “We Mapped the Uninsured. You’ll notice a Pattern: They tend to live in the South, and they tend to be poor” and op-eds with titles like “Do Poor People Have a Right to Health Care?” and “What it’s Like to Be Black and Pregnant when you Know How Dangerous That Can Be” run side-by-side with headlines touting “The Operating Room of the Future,” and advances in gene therapy that promise cures to everything form vision loss to cancer, accompanied by high six-figure price tags. Americans’ claims that they have access to the best medical care in the world are correct. Equally true are the claims that the system is broken.This chapter maps out the complex picture of access to medical care in the United States and reflects on how variable access illustrates, among other things, an American ambivalence about health solidarity. This Chapter first considers health care financing as one critical element that defines access to medical care and describes the multifaceted U.S. health care financing structure, predominated by public insurance programs for select populations and regulated private insurance for others. Second, this Chapter describes how access is equally shaped by legal requirements that create treatment obligations for doctors or hospitals, regardless of how someone pays for care. There is no constitutional right to health in the U.S., but various layers of statutory and common law have created some guarantees. That said, despite efforts to increase access over the past decades, the United States is still extraordinary, as compared to peer nations, on the unevenness of access to medical care among its population

Diabetic Adult Access to Medical Care and Race and Ethnicity in Connecticut

Diabetes is among the leading causes of death in Connecticut. An approximate of 330,000 adults in Connecticut have diabetes (diagnosed and undiagnosed). Those with diabetes have almost twice the risk of premature death throughout various age groups. The purpose of this cross-sectional study was to investigate whether disparities exist in access to medical care due to race and ethnicity; among adults with diabetes in the state of Connecticut. Furthermore, this study used the Andersen\u27s behavioral model framework. Survey data from the behavioral risk factor surveillance system (BRFSS) were also analyzed. The research study covered 3 years (2013 to 2015) of data collection in the BRFSS (N = 3,091). Race and ethnicity were the primary independent variables. The 3 dependent variables were: source of care, length of time since routine check-up, and doctor\u27s visit during the past 12 months. The overall data suggest that the disparity is significant in household income. Those who had healthcare coverage, higher income, and older age were significantly different from their counterparts in terms of length of time since the last routine checkup. In the regression analysis, healthcare coverage, income level and educational were the significant predictors of log length of time since the last routine checkup. Those who are Black, single, higher annual household income, and higher educational level, were significantly different from their counterparts in terms of doctors\u27 visits during the past 12 months. The implication for social change is that policymakers must act both to eliminate barriers and challenge structures that encourage disproportionate income advantages for White households

Lack of access to medical care during Hurricane Sandy and mental health symptoms

© 2018 The Authors Destruction caused by natural disasters compromises medical providers’ and hospitals’ abilities to administer care. Hurricane Sandy was particularly devastating, resulting in massive disruptions of medical care in the region. This study aimed to determine whether a lack of access to medical care during Hurricane Sandy was associated with posttraumatic stress disorder (PTSD) symptoms and other mental health/substance abuse outcomes. A secondary aim was to examine whether having a chronic illness moderates those associations. Self-reported medical access and mental health symptomatology were obtained from New York City and Long Island residents (n = 1669) following Hurricane Sandy under the Leaders in Gathering Hope Together project (10/23/2013–2/25/2015) and Project Restoration (6/5/2014–8/9/2016). Multivariable logistic regressions were utilized to determine the relationship between lack of access to medical care and mental health outcomes. Of the 1669 participants, 994 (59.57%) were female, 866 (51.89%) were white, and the mean age was 46.22 (SD = 19.2) years old. Those without access to medical care had significantly higher odds of showing symptoms of PTSD (AOR = 2.71, CI = [1.77–4.16]), as well as depression (AOR = 1.94, CI = [1.29–2.92]) and anxiety (AOR = 1.61, CI = [1.08–2.39]) compared to those with access. Lack of access to care was associated with a 2.12 point increase in perceived stress scale score (SE = 0.63). The interaction between having a chronic illness and lack of access to medical care was not significantly associated with any outcomes. The findings emphasize the importance of making medical care more accessible to patients, both chronically and acutely ill, during natural disasters to benefit their physical as well as their mental health