Association between utilization of preventive services and health insurance status: findings from the 2008 Behavioral...

To describe the uninsured population in the United States, to determine factors of uninsurance and to test the association between insurance status and use of preventive care.

Using the 2008 Behavioral Risk Factor Surveillance System, we conducted univariate logistic regression and stratified, multivariate and multinomial analyses, adjusting for confounders.

Respondents aged > or =65 years, regardless of their race/ethnicity, were much less likely to be uninsured than those aged 18 to 44 years. Lower annual income and unemployment were statistically significant factors of uninsurance for all racial/ethnic groups. Marital status was associated with lack of insurance, but only among non-Hispanic Whites, non-Hispanic Blacks and those in the other racial/ethnic category. Those with health insurance were almost 4 to 8 times more likely to report having one of more individuals they thought of as their personal doctor or healthcare provider. Compared to the uninsured, the insured had greater odds of having a physical within the past year, across all racial/ethnic groups. The same finding was true for having a dental check-up within the past year, but only among non-Hispanic Whites, non-Hispanic Blacks, and Hispanics.

The access of preventive care such as routine physical and dental exams differs by health insurance status and among racial/ethnic groups. As the number of uninsured grows, the US healthcare system needs to determine sustainable ways to increase health insurance coverage and improve access to preventive care for this population.