title: Diet quality, risk factors and access to care among low-income uninsured American adults in states expanding Medicaid vs. states not expanding under the affordable care act.
abstract: The Affordable Care Act (ACA) Medicaid expansion varies in availability across states.
  
  
  
  We compared characteristics of low-income uninsured residents in both Medicaid nonexpanding and expanding states with respect to their dietary quality, health risk factors, and access to care.
  
  
  
  Data from the 2007-2012 National Health and Nutrition Examination Survey was matched with the Kaiser Family Foundation Medicaid expansion data. Bivariate and multivariate regressions were estimated to assess differences across expanding and non-expanding states.
  
  
  
  The non-expansion group had a lower Healthy Eating Index score (41.8 vs. 44.1, p-value=0.006), a higher Body Mass Index (29.9 vs. 28.9, p-value=0.032), higher obesity prevalence (41% vs. 33%, p-value=0.007), and lower asthma prevalence (14.8% vs. 19.7%, p-value=0.037) compared with the expansion group.
  
  
  
  Differences across states in Medicaid coverage under the ACA may lead to widening disparities in health outcomes between expanding and non-expanding states.
authors: Independent Research Consultant, Mountain View, CA, USA. Electronic address: binh211@gmail.com.
authors: Binh T
authors: BT
authors: Nguyen
authors: American Cancer Society, Intramural Research Department, Atlanta, GA, USA.
authors: Xuesong
authors: X
authors: Han
authors: American Cancer Society, Intramural Research Department, Atlanta, GA, USA.
authors: Ahmedin
authors: A
authors: Jemal
authors: American Cancer Society, Intramural Research Department, Atlanta, GA, USA.
authors: Jeffrey
authors: J
authors: Drope
mesh_terms: D000328:Adult; D004032:Diet; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D009749:Nutrition Surveys; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence; D011203:Poverty / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States
keywords: Affordable Care Act; Diet quality; Medicaid expansion; Obesity