Gilbert Gonzales1,2, Carrie Henning-Smith3, Jesse M Ehrenfeld4,5. 1. Department of Medicine, Health and Society, Vanderbilt University, Nashville, Tennessee, USA. 2. Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 3. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA. 4. Department of Advancing a Healthier Wisconsin Endowment, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. 5. Division of AHW-Research and Education, Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Abstract
OBJECTIVE: To examine the changes in health insurance coverage, access to care, and health services utilization among nonelderly sexual minority and heterosexual adults between pooled years 2013-2014 and 2017-2018. DATA SOURCES: Data on 3223 sexual minorities (lesbians, gay men, bisexual individuals, and other nonheterosexual populations) and 86 181 heterosexuals aged 18-64 years were obtained from the 2013, 2014, 2017, and 2018 National Health Interview Surveys. STUDY DESIGN: Unadjusted and regression-adjusted estimates compared changes in health insurance status, access to care, and health services utilization for nonelderly adults by sexual minority status. Regression-adjusted changes were obtained from logistic regression models controlling for demographic and socioeconomic characteristics. PRINCIPAL FINDINGS: Uninsurance declined for both sexual minority adults (5 percentage points, P < .05) and heterosexual adults (2.5 percentage points, P < .001) between 2013-2014 and 2017-2018. Reductions in uninsurance for sexual minority and heterosexual adults were associated with increases in Medicaid coverage. Sexual minority and heterosexual adults were also less likely to report unmet medical care in 2017-2018 compared with 2013-2014. Low-income adults (regardless of sexual minority status) experienced relatively large increases in Medicaid coverage and substantial improvements in access to care over the study period. The gains in coverage and access to care across the study period were generally similar for heterosexual and sexual minority adults. CONCLUSIONS: Sexual minority and heterosexual adults have experienced improvements in health insurance coverage and access to care in recent years. Ongoing health equity research and public health initiatives should continue to monitor health care access and the potential benefits of recent health insurance expansions by sexual orientation and sexual minority status when possible.
OBJECTIVE: To examine the changes in health insurance coverage, access to care, and health services utilization among nonelderly sexual minority and heterosexual adults between pooled years 2013-2014 and 2017-2018. DATA SOURCES: Data on 3223 sexual minorities (lesbians, gay men, bisexual individuals, and other nonheterosexual populations) and 86 181 heterosexuals aged 18-64 years were obtained from the 2013, 2014, 2017, and 2018 National Health Interview Surveys. STUDY DESIGN: Unadjusted and regression-adjusted estimates compared changes in health insurance status, access to care, and health services utilization for nonelderly adults by sexual minority status. Regression-adjusted changes were obtained from logistic regression models controlling for demographic and socioeconomic characteristics. PRINCIPAL FINDINGS: Uninsurance declined for both sexual minority adults (5 percentage points, P < .05) and heterosexual adults (2.5 percentage points, P < .001) between 2013-2014 and 2017-2018. Reductions in uninsurance for sexual minority and heterosexual adults were associated with increases in Medicaid coverage. Sexual minority and heterosexual adults were also less likely to report unmet medical care in 2017-2018 compared with 2013-2014. Low-income adults (regardless of sexual minority status) experienced relatively large increases in Medicaid coverage and substantial improvements in access to care over the study period. The gains in coverage and access to care across the study period were generally similar for heterosexual and sexual minority adults. CONCLUSIONS: Sexual minority and heterosexual adults have experienced improvements in health insurance coverage and access to care in recent years. Ongoing health equity research and public health initiatives should continue to monitor health care access and the potential benefits of recent health insurance expansions by sexual orientation and sexual minority status when possible.
Authors: Michel Boudreaux; Jeanette Y Ziegenfuss; Peter Graven; Michael Davern; Lynn A Blewett Journal: Health Serv Res Date: 2010-10-28 Impact factor: 3.402
Authors: Rodman E Turpin; Natasha D Williams; Ellesse-Roselee L Akré; Bradley O Boekeloo; Jessica N Fish Journal: Int J Environ Res Public Health Date: 2022-04-21 Impact factor: 4.614