Community Uninsurance and Unmet Health Care Needs Is There a Spillover Effect for Rural Areas
Year: 2015
Type: article
Study design: Observational Study
Abstract: Prior research finds an individual's unmet need for health care is not solely determined by their insurance status but is in part influenced by the insurance status of the community.The uninsured experience greater chances of having an unmet need for health care, yet individuals with insurance also face a higher chance of unmet need when they live in areas with high levels of community uninsurance.There has been much research on the spillover effect and its impact on unmet need in the past decade.However, there is very little research that investigates this relationship outside of metropolitan areas.Using the BRFSS and SAHIE, this study examines the relationship between community uninsurance and unmet need among adults aged 18 to 64 (n i = 534,142) at the county level (n j = 2,281) paying special attention to rural/urban differences.Using the Andersen Model of Health Service Use as a guiding framework, this study uses a generalized estimating equation to test the spillover effect in urban, suburban, and rural areas.Results show that in rural areas community uninsurance has a dampening effect on access to care and it exacerbates the unmet need for both the insured and uninsured.However, in rural areas the overall chances of unmet need are lower in rural areas than urban or suburban areas.This study also finds that the effect of race/ethnicity and education on unmet are largely mediated by other factors.
Author: Michael Castro
Institution: Bowling Green State University
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2724630370