Role of Cancer History and Gender in Major Health Insurance Transitions: A Longitudinal Nationally Representative Study
Gender, Women’s Health Care Concerns and Other Social Factors in Health and Health Care
ISBN: 978-1-78756-176-2, eISBN: 978-1-78756-175-5
Publication date: 18 September 2018
Abstract
Purpose
To examine associations by gender between cancer history and major health insurance transitions (gains and losses), and relationships between insurance transitions and access to care.
Methodology
Longitudinal 2008–2013 Medical Expenditure Panel Survey data were pooled yielding 2,223 cancer survivors and 50,692 individuals with no cancer history ages 18–63 years upon survey entry, with gender-specific sub-analyses. Access-to-care implications of insurance loss or gain were compared by cancer history and gender.
Findings
Initially uninsured cancer survivors were significantly more likely to gain insurance coverage than individuals with no cancer history (RR: 1.25; 95% CI: 1.08–1.44). Females in particular were significantly more likely to gain insurance (unmarried RR: 1.16; 95% CI: 1.06–1.28; married RR: 1.09; 95% CI: 1.02–1.16). Significantly higher rates of difficulty accessing needed medical care and prescription medications were reported by those remaining uninsured, those who lost insurance, and women in general. Remaining uninsured, losing insurance, and male gender were associated with lack of a usual source of care.
Research implications
Additional outreach to disadvantaged populations is needed to improve access to affordable insurance and medical care. Future longitudinal studies should assess whether major Affordable Care Act (ACA) provisions enacted after the 2008–2013 study period (or those of ACA’s replacement) are addressing these important issues.
Originality
Loss of health insurance coverage can reduce health care access resulting in poor health outcomes. Cancer survivors may be particularly at risk of insurance coverage gaps due to the long-term chronic disease trajectory. This study is novel in exploring associations between cancer history by gender and health insurance transitions, both gains and losses, in a national non-elderly adult sample.
Keywords
Acknowledgements
Disclaimers
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of Emory University, University of Michigan, Yale University, the American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, or the Department of Veterans Affairs.
Conflict of Interest
The authors declare that they have no conflicts of interest.
Presentations
A preliminary version of this chapter “Impact of Health Insurance Transitions on Cancer Survivors and Those with No Cancer History,” with less years of data was presented at the 48th Annual Meeting of the American Society of Clinical Oncology, May 29–June 2, 2015, Chicago, IL, http://meetinglibrary.asco.org/content/150426-156 (Journal of Clinical Oncology 33s, 2015; abstract 6539).
Citation
Virgo, K.S., Lin, C.C., Davidoff, A., Guy, G.P., de Moor, J.S., Ekwueme, D.U., Kent, E.E., Chawla, N. and Yabroff, K.R. (2018), "Role of Cancer History and Gender in Major Health Insurance Transitions: A Longitudinal Nationally Representative Study", Gender, Women’s Health Care Concerns and Other Social Factors in Health and Health Care (Research in the Sociology of Health Care, Vol. 36), Emerald Publishing Limited, Leeds, pp. 59-84. https://doi.org/10.1108/S0275-495920180000036003
Publisher
:Emerald Publishing Limited
Copyright © 2018 Emerald Publishing Limited