title: Job loss and unmet health care needs in the economic recession: different associations by family income.
abstract: OBJECTIVE
  We examined heterogeneous associations between job loss and unmet health care needs by family income level in the recent economic recession.
  
  
  METHODS
  We conducted logistic regression analyses with the sample from the 2008 Survey of Income and Program Participation (n = 12,658). Dependent variables were 2 dichotomous measures of unmet health care needs in medical and dental services. The primary independent variables were a dummy indicator of job loss during a 2-year period and the family income-to-needs ratio. We used an interaction term between job loss and the family income-to-needs ratio to test the proposed research question.
  
  
  RESULTS
  Job loss was significantly associated with the increased risk of unmet health care needs. The proportion with unmet needs was highest for the lowest-income unemployed, but the association between job loss and health hardship was stronger for the middle- and higher-income unemployed.
  
  
  CONCLUSIONS
  The unemployed experience health hardship differently by income level. A comprehensive coordination of applications for unemployment and health insurance should be considered to protect the unemployed from health hardship.
authors.affiliation: Jin Huang and Julie Birkenmaier are with the College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO. Youngmi Kim is with the School of Social Work, Virginia Commonwealth University, Richmond.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.forename: Julie
authors.initials: J
authors.lastname: Birkenmaier
authors.forename: Youngmi
authors.initials: Y
authors.lastname: Kim
mesh_terms: D000328:Adult; D057172:Economic Recession / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D014478:Unemployment / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology