Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019
Smokers are more likely to be low-income with limited access to health services. Although Medicaid expansion under the Patient Protection and Affordable Care Act improved access to care for low-income adults, long-term trends in health care access among low-income smokers remain uncharacterized. The...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335522004132 |
| _version_ | 1828043806355750912 |
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| author | Andreas A. Teferra Jeffrey J. Wing Bo Lu Wendy Xu Megan E. Roberts Amy K. Ferketich |
| author_facet | Andreas A. Teferra Jeffrey J. Wing Bo Lu Wendy Xu Megan E. Roberts Amy K. Ferketich |
| author_sort | Andreas A. Teferra |
| collection | DOAJ |
| description | Smokers are more likely to be low-income with limited access to health services. Although Medicaid expansion under the Patient Protection and Affordable Care Act improved access to care for low-income adults, long-term trends in health care access among low-income smokers remain uncharacterized. The study evaluated changes in five access measures among low-income nonelderly (19–64) adults (N = 28976) across smoking status using pooled data from a statewide survey in Ohio covering pre- (i.e., 2012) and post-Medicaid expansion periods (2015, 2017, and 2019) guided by a comprehensive framework of health care access. We found improvements in some, but not all, health care access measures among low-income smokers in the post-Medicaid-expansion period compared to the pre-expansion period. Compared to 2012, the odds for unmet dental care needs declined in 2015 (aOR = 0.67, 95 % CI = 0.45–1.01), 2017 (aOR = 0.53, 95 % CI = 0.35–0.81), and 2019 (aOR = 0.65, 95 % CI = 0.40–1.05) (p trend < 0.001). Similarly, the odds for unmet other health care needs (i.e., medical exams and supplies) were lower in 2015 (aOR = 0.64, 95 % CI = 0.39–1.06), 2017 (aOR = 0.56, 95 % CI = 0.34–0.93), and 2019 (aOR = 0.47, 95 % CI = 0.27–0.83) (p trend < 0.001). Difficulty paying medical bills was also significantly lower in 2015 (aOR = 0.62, 95 % CI = 0.43–0.89), 2017 (aOR = 0.57, 95 % CI = 0.39–0.83) and 2019 (aOR = 0.57, 95 % CI = 0.37–0.87) (p trend < 0.001). While there was notable progress in measures of affordability (i.e., paying medical bills) as well as care availability and accommodation (i.e., unmet needs), there were no meaningful changes in the approachability of care (i.e., having a usual source of care). |
| first_indexed | 2024-04-10T17:46:33Z |
| format | Article |
| id | doaj.art-83d105d05b7c4c14b2f6e9e92e375ba2 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-04-10T17:46:33Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-83d105d05b7c4c14b2f6e9e92e375ba22023-02-03T04:57:47ZengElsevierPreventive Medicine Reports2211-33552023-02-0131102106Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019Andreas A. Teferra0Jeffrey J. Wing1Bo Lu2Wendy Xu3Megan E. Roberts4Amy K. Ferketich5Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA; Corresponding author at: Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, 431 S. 18th St., Columbus, OH, USA.Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USADivision of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USADivision of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USADivision of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USADivision of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USASmokers are more likely to be low-income with limited access to health services. Although Medicaid expansion under the Patient Protection and Affordable Care Act improved access to care for low-income adults, long-term trends in health care access among low-income smokers remain uncharacterized. The study evaluated changes in five access measures among low-income nonelderly (19–64) adults (N = 28976) across smoking status using pooled data from a statewide survey in Ohio covering pre- (i.e., 2012) and post-Medicaid expansion periods (2015, 2017, and 2019) guided by a comprehensive framework of health care access. We found improvements in some, but not all, health care access measures among low-income smokers in the post-Medicaid-expansion period compared to the pre-expansion period. Compared to 2012, the odds for unmet dental care needs declined in 2015 (aOR = 0.67, 95 % CI = 0.45–1.01), 2017 (aOR = 0.53, 95 % CI = 0.35–0.81), and 2019 (aOR = 0.65, 95 % CI = 0.40–1.05) (p trend < 0.001). Similarly, the odds for unmet other health care needs (i.e., medical exams and supplies) were lower in 2015 (aOR = 0.64, 95 % CI = 0.39–1.06), 2017 (aOR = 0.56, 95 % CI = 0.34–0.93), and 2019 (aOR = 0.47, 95 % CI = 0.27–0.83) (p trend < 0.001). Difficulty paying medical bills was also significantly lower in 2015 (aOR = 0.62, 95 % CI = 0.43–0.89), 2017 (aOR = 0.57, 95 % CI = 0.39–0.83) and 2019 (aOR = 0.57, 95 % CI = 0.37–0.87) (p trend < 0.001). While there was notable progress in measures of affordability (i.e., paying medical bills) as well as care availability and accommodation (i.e., unmet needs), there were no meaningful changes in the approachability of care (i.e., having a usual source of care).http://www.sciencedirect.com/science/article/pii/S2211335522004132SmokersHealth care accessMedicaidPreventive careLow-income |
| spellingShingle | Andreas A. Teferra Jeffrey J. Wing Bo Lu Wendy Xu Megan E. Roberts Amy K. Ferketich Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019 Preventive Medicine Reports Smokers Health care access Medicaid Preventive care Low-income |
| title | Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019 |
| title_full | Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019 |
| title_fullStr | Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019 |
| title_full_unstemmed | Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019 |
| title_short | Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019 |
| title_sort | examining trends in health care access measures among low income adult smokers in ohio 2012 2019 |
| topic | Smokers Health care access Medicaid Preventive care Low-income |
| url | http://www.sciencedirect.com/science/article/pii/S2211335522004132 |
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