Health Insurance and Chronic Conditions in Low-Income Urban Whites

• Published in: Journal of urban health 2014-08, Vol.91 (4), p.637-647
• Main Authors: Smolen, J. R., Thorpe, Roland J., Bowie, J. V., Gaskin, D. J., LaVeist, T. A.
• Format: Article
• Language: English
• Subjects: Adult; Baltimore - epidemiology; Chronic Disease - economics; Chronic Disease - epidemiology; Chronic illnesses; Cross-Sectional Studies; Epidemiology; European Continental Ancestry Group - statistics & numerical data; Female; Health Informatics; Health insurance; Humans; Hypertension; Income; Insurance Coverage - statistics & numerical data; Insurance, Health - statistics & numerical data; Low income groups; Male; Medically Uninsured - statistics & numerical data; Medicine; Medicine & Public Health; Middle Aged; Patient Protection & Affordable Care Act 2010-US; Patient Protection and Affordable Care Act - statistics & numerical data; Poverty - statistics & numerical data; Prevalence; Public Health; Socioeconomic Factors; United States; Urban areas; Urban Population - statistics & numerical data; White people
• ISSN: 1099-3460; 1468-2869
• DOI: 10.1007/s11524-014-9875-6

Little is known about how health insurance contributes to the prevalence of chronic disease in the overlooked population of low-income urban whites. This study uses cross-sectional data on 491 low-income urban non-elderly non-Hispanic whites from the Exploring Health Disparities in Integrated Communities—Southwest Baltimore (EHDIC-SWB) study to examine the relationship between insurance status and chronic conditions (defined as participant report of ever being told by a doctor they had hypertension, diabetes, stroke, heart attack, anxiety or depression, asthma or emphysema, or cancer). In this sample, 45.8 % were uninsured, 28.3 % were publicly insured, and 25.9 % had private insurance. Insured participants had similar odds of having any chronic condition (odds ratios (OR) 1.06; 95 % confidence intervals (CI) 0.70–1.62) compared to uninsured participants. However, those who had public insurance had a higher odds of reporting any chronic condition compared to the privately insured (OR 2.29; 95 % CI 1.21–4.35). In low-income urban areas, the health of whites is not often considered. However, this is a significant population whose reported prevalence of chronic conditions has implications for the Medicaid expansion and the implementation of health insurance exchanges.