Unmet Healthcare Needs and Healthcare Access Gaps Among Uninsured U.S. Adults Aged 50-64.

Namkee G Choi,Bryan Y Choi,Diana M Dinitto

doi:10.3390/ijerph17082711

Abstract

Lack of health insurance (HI) is a particular problem for near-older Americans aged 50–64 because they tend to have more chronic health conditions than younger age groups and are at increased risk of disability; however, little recent research has focused on HI coverage and healthcare access among this age group. Using the U.S. National Health Interview Survey data for the years 2013 to 2018, we compared HI coverage and healthcare access between the 50–64 and 65+ age groups. Using logistic regression analysis, we then examined the sociodemographic and health characteristics of past-year healthcare access of near-older Americans without HI to those with private HI or public HI (Medicare without Medicaid, Medicaid without Medicare, Medicare and Medicaid, and VA/military HI). We estimated the odds of healthcare access among those without HI compared to those with private or public HI. Near-older Americans without HI were at least seven times more likely to have postponed or foregone needed healthcare due to costs, and only 15% to 23% as likely to have had contact with any healthcare professional in the preceding 12 months. Expanding HI to near-older adults would increase healthcare access and likely result in reduced morbidity and mortality and higher quality of life for them.

Highlights

Americans aged 50–64 constitute almost 20% of the U.S population [1]
We estimated the odds of healthcare access among those without health insurance (HI) compared to those with private or public HI
Obtaining health insurance (HI) and healthcare is difficult for many Americans, because the United States is the only developed country that lacks universal health coverage

Summary

Introduction

Americans aged 50–64 constitute almost 20% of the U.S population [1]. This age group, often referred to as “near-older adults,” is at substantial risk of multiple chronic health conditions and disability. 45–64 age group, compared to 7.3% of the 18–44 age group, had two or more chronic health conditions (including arthritis, asthma, cancer, chronic obstructive pulmonary disease, coronary heart disease, diabetes, hepatitis, hypertension, stroke, or weak/failing kidneys) [2]. The working-age population (18–64 years) with chronic conditions has significantly higher odds of experiencing an uninsured period and reporting healthcare access barriers than those without chronic conditions [3,4]. Obtaining health insurance (HI) and healthcare is difficult for many Americans, because the United States is the only developed country that lacks universal health coverage. According to the Organisation for Economic Co-operation and Development (OECD), universal health coverage improves health outcomes, including life expectancy, and provides financial protection against impoverishing health care costs [5]

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