There has
been recent buzz around looking at how certain factors such as income,
education, employment, and access to resources impact health. For example,
recent studies have looked at the relationship between housing and health
outcomes, positing that unstable housing relates to poor health. However, there is
little evidence on the link between housing and health insurance coverage, as
well as whether the passage of the Affordable Care Act (ACA) and Medicaid
expansion plays a role in this relationship.
A recent
fact sheet by researchers at the UCLA Center for Health Policy Research and Claremont
Graduate University shows that people who have complete housing amenities are more
likely to have health insurance than those who are missing at least one amenity,
both before and after the ACA’s implementation and independent of income. Missing
amenities include housing that lacks a bathtub or shower, sink with a faucet,
stove or range, or refrigerator.
“We found
that people who may otherwise have access to no-cost insurance such as Medicaid
are struggling to maintain basic necessities,” said Deborah Freund, lead author of the
study and an economic sciences professor at Claremont Graduate University.
Using
data from the American Community Survey from 2013 to 2018, researchers looked
at the percentage of adults up to 64 years old who were uninsured based on
whether they had all basic home necessities versus people who were missing at
least one of those features. They found that those missing at least one basic
home necessity and having incomes less than 100% of the Federal Poverty Level
(FPL) had the highest uninsured rates in 2013 (33.5%) and 2018 (23%) compared
with those who had all basic necessities (27.4% in 2013 and 17% in 2018). The
same trend was true for people with income levels of 100-399% FPL and 400% FPL
– though the differences were not drastically different in the highest income
category.
“Future
research should look more closely at housing as a social determinant of health,
especially in relation to insurance coverage, as there may be important factors
– lack of awareness of available resources, life burdens, and other budget
priorities – uncovered that should be addressed to bridge the gap in needs and
services for underserved communities,” Freund said.
This study
was conducted jointly by the UCLA Center for Health Policy Research and
the Claremont Graduate University with support from
the A-Mark Foundation. This is in addition to a fact sheet on the link between
education and insurance coverage, and will be part of a larger report examining
several other factors.