Study finds Medicaid expansion in Kentucky provided most benefit to those in poorer areas

May 01, 2017

The implementation of the Affordable Care Act (ACA) in Kentucky proved most beneficial for Kentuckians living in areas with high concentrations of poverty, particularly children, according to a study by a researcher in the University of Louisville School of Public Health and Information Sciences in collaboration with colleagues at Ohio State University and Emory University. The study was published recently in Health Services Research.

Joseph Benitez, Ph.D., assistant professor in UofL's Department of Health Management and System Sciences and member of the school's Commonwealth Institute of Kentucky, said the findings suggest expanding Medicaid is one mechanism that largely helped to address many of the health care needs of some of the poorest Kentuckians.

"Most of the reduction in Kentucky's uninsured rate between 2013 through 2015 was driven by an uptake in coverage within ZIP codes of high poverty concentrations," Benitez said. "Similarly, the study revealed statistically and substantively meaningful reductions in the number of Kentuckians who delayed or decided not to seek medical care due to cost, in addition to having a regular source of medical care. These findings were almost entirely concentrated among Kentuckians living in poorer ZIP codes."

Utilizing a version of the Behavioral Risk Factor Surveillance System (BRFSS) from Kentucky's Department for Public Health, the study compared trends before and after implementation of the ACA in health insurance coverage, access measures and health care utilization for Kentuckians in higher verses lower poverty ZIP codes.

This builds on a previous study conducted by Benitez and his UofL colleagues that found the uninsured rate among Kentucky households with annual incomes below $25,000 dropped from 35 percent in 2013 to almost 10 percent by the end of 2014. The same households also saw a 50 percent reduction in the number of those foregoing medical care because of high costs.

Benitez says although it may be too early to identify meaningful improvement in health status of Kentuckians, given the promising results for coverage, access and utilization among some of the most economically vulnerable population, positive long-term health effects are likely.

"It is clear from this study that expanding Medicaid helps address the health care needs of the impoverished. Using Kentucky as a case example to study the effects of the ACA across geographic areas holds lessons for policy makers weighing the costs and benefits of ACA participation," Benitez said.
-end-


University of Louisville

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.