title: Supplemental private health insurance and depressive symptoms in older married couples.
abstract: Stress process theory is applied to examine lack of supplemental private health insurance as a risk factor for depressive symptomatology among older married couples covered by Medicare. Dyadic data from 130 African-American couples and 1,429 White couples in the 1993 Asset and Health Dynamics Among the Oldest-Old Survey were analyzed using hierarchical generalized linear modeling. Lack of supplemental insurance is operationalized at the household level in terms of neither spouse covered, one spouse covered, or both spouses covered. Controlling for covariates at both individual and couple levels, supplemental insurance has significant impact on depression, but the pattern differs by race. White couples report the highest depression when neither spouse is covered by private health insurance; African-American couples report the highest depression when only one spouse is covered. Results suggest lack of supplemental private health insurance coverage is a stressor that significantly affects depressive symptoms.
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, OH 44106-7164, USA. mxo7@case.edu
authors.forename: Meeyoung Oh
authors.initials: MO
authors.lastname: Min
authors.forename: Aloen L
authors.initials: AL
authors.lastname: Townsend
authors.forename: Baila
authors.initials: B
authors.lastname: Miller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rovine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D044383:Black People / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D012307:Risk Factors; D018454:Spouses / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American