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Community Uninsurance and Unmet Health Care Needs Is There a Spillover Effect for Rural Areas?

Castro, Michael

Abstract Details

2015, Master of Arts (MA), Bowling Green State University, Sociology.
Prior research finds an individual’s unmet need for health care is not solely determined by their insurance status but is in part influenced by the insurance status of the community. The uninsured experience greater chances of having an unmet need for health care, yet individuals with insurance also face a higher chance of unmet need when they live in areas with high levels of community uninsurance. There has been much research on the spillover effect and its impact on unmet need in the past decade. However, there is very little research that investigates this relationship outside of metropolitan areas. Using the BRFSS and SAHIE, this study examines the relationship between community uninsurance and unmet need among adults aged 18 to 64 (ni = 534,142) at the county level (nj = 2,281) paying special attention to rural/urban differences. Using the Andersen Model of Health Service Use as a guiding framework, this study uses a generalized estimating equation to test the spillover effect in urban, suburban, and rural areas. Results show that in rural areas community uninsurance has a dampening effect on access to care and it exacerbates the unmet need for both the insured and uninsured. However, in rural areas the overall chances of unmet need are lower in rural areas than urban or suburban areas. This study also finds that the effect of race/ethnicity and education on unmet are largely mediated by other factors.
Kelly Balistreri, PhD (Advisor)
Laura Sanchez, PhD (Committee Member)
I-Fen Lin, PhD (Committee Member)
79 p.

Recommended Citations

Citations

  • Castro, M. (2015). Community Uninsurance and Unmet Health Care Needs Is There a Spillover Effect for Rural Areas? [Master's thesis, Bowling Green State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1438274280

    APA Style (7th edition)

  • Castro, Michael. Community Uninsurance and Unmet Health Care Needs Is There a Spillover Effect for Rural Areas? 2015. Bowling Green State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1438274280.

    MLA Style (8th edition)

  • Castro, Michael. "Community Uninsurance and Unmet Health Care Needs Is There a Spillover Effect for Rural Areas?" Master's thesis, Bowling Green State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1438274280

    Chicago Manual of Style (17th edition)