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Uninsured in America: Individual and Community Factors
Does an individual’s community have an impact on the decision to purchase health insurance in the private market? A team of University of Washington researchers examined whether community-level characteristics, such as unequal income distribution, segregation in housing, and availability of safety-net services, affect not only the decision to purchase private health insurance, but also the access to care of uninsured persons. Access was measured using estimates of services available to uninsured or vulnerable populations in the community (e.g., the community’s “safety net”), as well as whether the availability of safety net services influences low-income individuals’ and families’ decisions about whether or not to purchase individual insurance. In addition, the researchers estimated the probability of purchasing individual insurance, delaying or not obtaining care, utilizing outpatient services, and having a regular source of care. They used the Community Tracking Study Household Survey, along with data from HCFA, the American Hospital Association, the U.S. Census Bureau, the Area Resource File, the Urban Institute’s “Assessing the New Federalism” project, and The George Washington University data on the percent of medically underserved persons served by federal and state funds or programs. The project’s objectives were to: 1) assess how individual, community, and state-level factors affect the decision to remain uninsured or to purchase individual health insurance and whether those factors explain lower rates of individual insurance purchased by minorities; and 2) describe access problems experienced by the uninsured.
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