Unemployment Linked to Reduced Use of Preventive Health Care

Release Date: July 23, 2013 | By Valerie DeBenedette, HBNS Contributing Writer
Research Source: Health Services Research

KEY POINTS

  • A one percent increase in state unemployment corresponded to a 1.58 percent reduction in the use of preventive health care services such as mammograms, pap tests, and annual check-ups.
  • Women and people who are already economically disadvantaged were especially sensitive to economic fluctuations.
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Fluctuations in the unemployment rate affect people’s health care choices, finds a new study in Health Services Research. Specifically, a one percent increase in state unemployment corresponded to a 1.58 percent reduction in the use of preventive health care services such as mammograms, pap tests, and annual check-ups.

“A one percentage point change in the unemployment rate is a substantial shift in employment conditions, and the associated change in preventive services is similarly important,” said Nathan Tefft, Ph.D., assistant professor in the School of Public Health at the University of Washington, Seattle, and lead author on the study.

The findings are based on an analysis of data from surveys conducted by the U.S. Centers for Disease Control and Prevention between 1987 and 2010. The researchers compared this information with macroeconomic data on state unemployment rates and annual per capita income from the U.S. Department of Labor Statistics.

After controlling for per capita personal income, use of preventive services declined with increased unemployment, especially for working age adults. A smaller decrease was seen in people over age 65, who are usually covered by Medicare. Women and people who are already economically disadvantaged were especially sensitive to economic fluctuations.

Preventive medical care is underutilized in the United States, with only about half of the population following recommended guidelines, note the researchers. Furthermore, they suggest, preventive care can carry a relatively high one-time cost and may be more likely to be seen as a relative luxury, therefore changes in income, or fears of an impending loss of income during a downturn, may have a greater effect on their use.

Health care providers should consider factors such as economic downturns when advising patients about preventive care or exams to ensure that they make the best choices, the researchers say.

“If patients are under financial or other distress and decide that they need to forego some treatments, then their doctor could play a crucial role in helping them think through that decision,” Tefft said.

These results validate what public health professionals already know, said Georges C. Benjamin, M.D., executive director of the American Public Health Association in Washington. “We know that having less income automatically reduces one’s access to services for a variety of reasons.” People put off non-emergency health decisions when money is tight, he noted. “Unless people perceive a problem to be an emergency, they are less likely to have it taken care of.”

TERMS OF USE: This story is protected by copyright. When reproducing any material, including interview excerpts, attribution to the Health Behavior News Service, part of the Center for Advancing Health, is required. While the information provided in this news story is from the latest peer-reviewed research, it is not intended to provide medical advice or treatment recommendations. For medical questions or concerns, please consult a health care provider.

For More Information:

Please reach the Health Behavior News Service, part of the Center for Advancing Health, at (202) 387-2829 or hbns-editor@cfah.org

Health Services Research is the official journal of the Academy Health and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422 2646 or jshaw@aha.org. HSR is available online at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1475-6773/

State-Level Unemployment and the Utilization of Preventive Medical Services, Nathan Tefft and Andrew Kageleiry. Health Services Research. Article first published online: 16 JUL 2013 | DOI: 10.1111/1475-6773.12091

 

 

Tags for this article:
Health Care Access   Disease Screening   Health Care Cost   Find Good Health Care   Pay for your Health Care   Women's Health   Men's Health  



Comments on this article
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Ellen says
July 25, 2013 at 11:55 AM

Spot on. I've been laid off three times in the past five years. Preventive healthcare, were I to choose it, would be at the expense of groceries, electricity, phone, and other living expenses. (There is no entertainment/dining out line item in my budget.) Therefore, it isn't a choice.

Also, you might be interested to know that Pamela Miles of Reiki, Medicine, and Self-Care has featured this article on her Facebook page for discussion purposes.