title: Health insurance and chronic conditions in low-income urban whites.
abstract: Little is known about how health insurance contributes to the prevalence of chronic disease in the overlooked population of low-income urban whites. This study uses cross-sectional data on 491 low-income urban non-elderly non-Hispanic whites from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) study to examine the relationship between insurance status and chronic conditions (defined as participant report of ever being told by a doctor they had hypertension, diabetes, stroke, heart attack, anxiety or depression, asthma or emphysema, or cancer). In this sample, 45.8 % were uninsured, 28.3 % were publicly insured, and 25.9 % had private insurance. Insured participants had similar odds of having any chronic condition (odds ratios (OR) 1.06; 95 % confidence intervals (CI) 0.70-1.62) compared to uninsured participants. However, those who had public insurance had a higher odds of reporting any chronic condition compared to the privately insured (OR 2.29; 95 % CI 1.21-4.35). In low-income urban areas, the health of whites is not often considered. However, this is a significant population whose reported prevalence of chronic conditions has implications for the Medicaid expansion and the implementation of health insurance exchanges.
authors.affiliation: Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Smolen
authors.forename: Roland J
authors.initials: RJ
authors.lastname: Thorpe
authors.forename: J V
authors.initials: JV
authors.lastname: Bowie
authors.forename: D J
authors.initials: DJ
authors.lastname: Gaskin
authors.forename: T A
authors.initials: TA
authors.lastname: LaVeist
mesh_terms: D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*