Impact of cost problems on morbidity in a hypertensive population

Researchers disagree about the extent to which limited access to health services negatively affects health. In this study, we investigated the association of health status with access to high blood pressure medication among hypertensive respondents drawn from two random household surveys conducted in the state of Georgia during 1981 and 1983. We compared hypertensive respondents reporting difficulties in paying for medication (n = 616) with hypertensive respondents not reporting cost problems (n = 616) who were matched on race, sex, age (+/- 3 years), and per capita family income (+/- $3,000). Because questions were not identical in the 1981 and 1983 surveys, we compared responses of the matched groups separately for each year in the analysis. In the 1981 comparison, a significantly higher (P less than .05) percentage of hypertensive individuals experiencing cost problems reported being in fair or poor health (60.5%) and having had a stroke (11.4%) than those without cost problems (39% for fair or poor health status and 5% for occurrence of stroke). Those with cost problems also reported a higher frequency of cardiac problems (24.6%) than those without cost problems (18.1%), although these differences are not statistically significant (P greater than .05). In the 1983 survey, a significantly larger number of those with cost problems (57.4%) reported being in fair or poor health than those without cost problems (43.1%, P less than .05).