Being without health insurance or being “underinsured” creates a variety of special problems for women aged 45 to 64, which is perhaps the most complex of all developmental periods in the lives of American women. “One Thing Follows Another. . .” explored the relationship between health insurance status and the utilization of primary screening services among women, aged 45 to 64.
Secondary data drawn from the 1996 BRFSS was used to develop a non-experimental study that examined the association between health insurance status, and access to selected primary screening services as measured from their responses to the BRFSS and as compared to demographic covariates of interest.
Several key findings emerged:
- Health insurance significantly affects a woman’s use of primary health care services;
- While insurance status or lack of coverage matters tremendously for women, it alone does not guarantee access to health care.
- Other determinants, such as income and educational levels, are important forces affecting health behaviors;
- The rate of being uninsured in the 45-64 females cohort was slightly higher than the national averages in 1996;
- Reduced rates of access were observed across all covariates when women did not have insurance but higher rates of poor outcomes were more consistently associated with uninsured women who were of a race or ethnicity other than “White Non-Hispanic,” were unmarried, were unemployed and had lower levels of income and less years of education completed.
The public health significance of the study relates directly to one of the Year 2010 National Health Objectives — to increase the proportion of persons with health insurance to 100 percent. To meet that goal, all Americans should be included in a comprehensive health care system that guarantees timely access to health care, assures a high quality of health services with adequate and stable reimbursement for health care providers and rationally apportion the costs of care.
A major focus of that process should include current and immediate attention toward improving the health care of all women, with a special emphasis on those aged 45 to 64, who have inadequate insurance coverage. The final chapter includes a review of current state health care reform initiatives and several major approaches to extending coverage to midlife women. Public health and social policy implications along with suggestions for future research and the study’s limitations are also provided.
One thing leads to another—Examining the relationship between health insurance status and access to selected screening services by women, aged 45 to 64.
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