Sex-Based Differences in Association Between Coverage Disruptions and Preventive Care

Adults with part-year or year-round uninsurance are less likely to receive recommended preventive services. Sex differences in preventive care use have been documented, but it remains unclear whether sex moderates the association between insurance coverage disruptions and preventive care use. The current study analyzed data from 37,659 adults aged 18-64 in the 2019 and 2023 National Health Interview Survey. Insurance coverage over the past 12 months was categorized as continuous private, continuous public, coverage gap, or continuously uninsured. Outcomes included blood pressure and cholesterol tests, having a usual source of care, dental and eye exams, preventive care visits, and unmet need for medical care. Each outcome was analyzed using multivariate logistic regression interacting insurance category with sex. Continuously uninsured adults or adults with coverage gaps in the past 12 months reported lower preventive care utilization and higher unmet need for medical care than adults who were continuously insured. Relationships between part-year or year-round uninsurance and preventive care generally did not vary by sex. Female respondents with continuous public insurance were less likely to report a usual source of care but had lower unmet needs for medical care than female respondents with continuous private insurance. Health insurance coverage disruptions are associated with reduced use of preventive services regardless of sex. Policies promoting continuity of health insurance coverage may improve uptake of preventive services and reduce unmet needs for medical care.