Young adults in Massachusetts: who is at risk of being uninsured?
OBJECTIVE
To identify sociodemographic factors associated with being uninsured among young adults in a state sample (Massachusetts) and to examine the independent association of insurance status with the young adult's reporting no health maintenance visit (check-up) in the past 2 years or reporting an inability to afford needed health care in the last 12 months.


METHODS
Secondary analysis of data from the Massachusetts Behavioral Risk Factor Surveillance System for the years 1998-2000. In this cross-sectional study, data were examined for 1673 19- to 24-years-olds who provided information on sociodemographic variables, health insurance status, perceived inability to afford care, and health care use. Multiple logistic regression was used to estimate the odds of being uninsured. Subsequently, multiple logistic regression was used to estimate the odds of having no check-up in the last 2 years and of reporting the inability to afford needed health care in the last year.


RESULTS
15% of young adults were uninsured, including 20% of males and 10% of females. For both genders, the adjusted odds of being uninsured were lower for students and higher for those with a household income between 15,000 dollars and 24,999 dollars. Uninsured young men, but not women, had significantly higher odds of not having a routine check-up in the last 2 years. Uninsured young adults of both genders had significantly higher odds of reporting the inability to afford needed care in the past 12 months.


CONCLUSIONS
Programs and policies that seek to reduce the rates of uninsured young adults should especially target males and nonstudents. Improving health insurance coverage, especially for young adult males, may be associated with improved preventive health care access.
Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA. todd.callahan@vanderbilt.edu
S Todd
ST
Callahan
Elizabeth R
ER
Woods
S Bryn
SB
Austin
Sion Kim
SK
Harris
D000328:Adult; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D008404:Massachusetts; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors