By: Jennifer Chubinski
In my last blog, I wrote about what we call, “up-stream factors” in health. Those are health behaviors that could help you live a longer and healthier life. Those behaviors were: not smoking, eating a healthy diet, getting regular exercise, and limiting alcohol consumption. While these behaviors are helpful in keeping you healthy, it is also important to have access to regular healthcare for regular check-ups or when you are sick. So what does healthcare access look like for adults in Greater Cincinnati (results based on the 2013 Greater Cincinnati Health Status Survey)?
Insurance Status: having health insurance is a critical factor in whether someone seeks appropriate healthcare in a timely manner. Those who are uninsured are much less likely to get care when they need it. At the end of 2013, before the implementation of the Affordable Care Act (ACA) we asked adults in our region about their insurance status. Because nearly all adults in our region 65 and older (99.6%) are insured, mostly through Medicare, these insurance data focus on working ages adults (18-64). At the end of 2013 we saw just under 2 in 10 (19%) Cincinnati adults reporting being currently uninsured, similar to the nation and our regional data from 2010.
The stability of health insurance coverage is also an important factor in access to healthcare. A measure of stability is whether a person has been covered continuously for the past 12 months. About 6% of currently insured adults in our region report having been without insurance at some point in the last 12 months; this is unchanged from 2010.
With the implementation of the ACA we expect to see dramatic drops in the number of working-age adults reporting that they are uninsured. We have started to see some of those changes in data collected for the Ohio Health Issues Poll (OHIP) with the percentage of uninsured dropping to 11%, the lowest in poll history. Based on national research we expect uninsurance rates in our community to drop to about half of their 2013 levels.
Access to a usual and appropriate source of care: An appropriate place for healthcare is more than just a regular place to go. It is where you and your health history are known to the provider. This allows for regular and preventive care and can help catch minor problems before they become serious. This is why having a usual and appropriate place of care is one of the Community’s Bold Goals for health improvement. The goal is that 95% of residents in Greater Cincinnati report having a usual and appropriate place of healthcare.
So how are adults in Greater Cincinnati doing on this measure of healthcare access? A majority of adults in our community report having a usual and appropriate place for healthcare. About 8 in 10 (82%) report having a usual and appropriate place for healthcare. This is an increase from previous years, but is still below the community’s Bold Goal of 95%.
Finding a trusted healthcare provider: Research has shown that trust between a patient and provider is important for creating an effective care environment. Trust leads to increased patient satisfaction and better compliance with treatment recommendations. However, finding a trusted healthcare provider is not always easy for everyone. The Greater Cincinnati Community Health Status Survey asked if either a lack of health insurance or the type of health insurance has been a barrier to finding a trusted healthcare provider. Responses to these questions are similar – About 2 in 10 adults (19%) in Greater Cincinnati say the lack of insurance or type of insurance prevents them from finding a trusted provider. However the young, poor, African Americans, and less educated are more likely to report insurance as a barrier.
Respondents were also asked if race or ethnicity was a barrier to finding a trusted provider. African Americans, people of other races, and those who were poor or uninsured were more likely to report race or ethnicity as a barrier to finding a trusted healthcare provider.
It seems as if the deck is stacked against the poor, less educated and minorities when it comes to healthcare access. What will it take to change these statistics?
 For this analysis private doctors’ offices, community-based health clinics, public health clinics, clinics at retail stores, and hospital outpatient departments are considered appropriate sources of healthcare.