Analyzing disparity trends for health care insurance coverage among non-elderly adults in the US: evidence from the Behavioral Risk Factor Surveillance System, 1993–2009

Details

• Alternative Title:
  Eur J Health Econ
• Personal Author:
  Assaf, Shireen ; Campostrini, Stefano ; Di Novi, Cinzia ; Xu, Fang ; Gotway Crawford, Carol
• Description:
  Objective
  
  To explore the changing disparities in access to health care insurance in the United States using time-varying coefficient models.
  
  Data
  
  Secondary data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1993 to 2009 was used.
  
  Study design
  
  A time-varying coefficient model was constructed using a binary outcome of no enrollment in health insurance plan versus enrolled. The independent variables included age, sex, education, income, work status, race, and number of health conditions. Smooth functions of odds ratios and time were used to produce odds ratio plots.
  
  Results
  
  Significant time-varying coefficients were found for all the independent variables with the odds ratio plots showing changing trends except for a constant line for the categories of male, student, and having three health conditions. Some categories showed decreasing disparities, such as the income categories. However, some categories had increasing disparities in health insurance enrollment such as the education and race categories.
  
  Conclusions
  
  As the Affordable Care Act is being gradually implemented, studies are needed to provide baseline information about disparities in access to health insurance, in order to gauge any changes in health insurance access. The use of time-varying coefficient models with BRFSS data can be useful in accomplishing this task.
  
  
• Keywords:
  Adolescent Adult Age Distribution Behavioral Risk Factor Surveillance System Disparities Female Health Insurance Health Status Health Surveillance Data Humans I14 Insurance, Health Insurance Coverage Male Middle Aged P-splines Patient Protection And Affordable Care Act Sex Distribution Socioeconomic Factors Temporal Trends United States Varying Coefficient Model Young Adult

  More +
• Source:
  Eur J Health Econ. 18(3):387-398
• Pubmed ID:
  27241187
• Pubmed Central ID:
  PMC10884940
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  18
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3acde8e349a5db5d50578d1146879ab0ef2fc32a7f31b222d23705c15a81efe0
• Download URL:
  https://stacks.cdc.gov/view/cdc/150322/cdc_150322_DS1.pdf
• File Type:
  [PDF - 740.80 KB ]