title: Place as a predictor of health insurance coverage: A multivariate analysis of counties in the United States.
abstract: This study assessed the importance of county characteristics in explaining county-level variations in health insurance coverage. Using public databases from 2008 to 2012, we studied 3112 counties in the United States. Rates of uninsurance ranged widely from 3% to 53%. Multivariate analysis suggested that poverty, unemployment, Republican voting, and percentages of Hispanic and American Indian/Alaskan Native residents in a county were significant predictors of uninsurance rates. The associations between uninsurance rates and both race/ethnicity and poverty varied significantly between metropolitan and non-metropolitan counties. Collaborative actions by the federal, tribal, state, and county governments are needed to promote coverage and access to care.
authors.affiliation: Public Health Program, Department of Family & Community Medicine, University of New Mexico Health Sciences Center, MSC 095060, 1 University, Albuquerque, NM 87131, United States; Robert Wood Johnson Foundation Center for Health Policy, University of New Mexico Health Sciences Center, MSC 095060, 1 University, Albuquerque, NM 87131, United States; Community Engagement Core, NM CARES Health Disparities Center, University of New Mexico Health Sciences Center, MSC 095060, 1 University, Albuquerque, NM 87131, United States; U.S.-Mexico Border Center of Excellence Consortium, University of New Mexico Health Sciences Center, MSC 095060, 1 University, Albuquerque, NM 87131, United States. Electronic address: Lcacari-stone@salud.unm.edu.
authors.forename: Lisa Cacari
authors.initials: LC
authors.lastname: Stone
authors.affiliation: College of Nursing, University of New Mexico, MSC09 5350, 1 University of New Mexico, Albuquerque, NM 87131, United States. Electronic address: bboursaw@salud.unm.edu.
authors.forename: Blake
authors.initials: B
authors.lastname: Boursaw
authors.affiliation: RWJF Center for Health Policy, University of New Mexico, PO Box 90, Corrales, NM 87048-0090, United States. Electronic address: spbettez@unm.edu.
authors.forename: Sonia P
authors.initials: SP
authors.lastname: Bettez
authors.affiliation: American Indian Studies at Arizona State University, United States. Electronic address: Tennille.Marley@asu.edu.
authors.forename: Tennille
authors.initials: T
authors.lastname: Larzelere Marley
authors.affiliation: Robert Wood Johnson Foundation Center for Health Policy, University of New Mexico Health Sciences Center, MSC 095060, 1 University, Albuquerque, NM 87131, United States; Department of Sociology, University of New Mexico; Department of Internal Medicine, University of Illinois; School of Public Health, University of Puerto Rico, 5406 East Drive, Loves Park, IL 61111, United States. Electronic address: waitzkin@unm.edu.
authors.forename: Howard
authors.initials: H
authors.lastname: Waitzkin
mesh_terms: D019352:Censuses; D005006:Ethnicity / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health; D009111:Local Government; D011203:Poverty; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014478:Unemployment; D014481:United States
keywords: County government; Health care access; Health reform; Insurance coverage