Joanne T

The plight of single women who are heads of females and are uninsured who are caring for young children is a significant issue in our society.  The reality of health disparities and its relationship with being uninsured within the United States is well documented by research and government agencies.  According to Rosenblum (2008), there are certain demographic characteristics that increase the risk of women to be uninsured. These include minority status and single parenthood among other things. According to the Agency for Healthcare Research and Quality (AHRQ) and the Health Resources and Services Administration (HRSA) , 2010), the percentage of persons of all ages without health insurance coverage between 1997 – 2010 is 15.4% or 46.7 million individuals.   Research has revealed various reasons for this disparity. They include racial, political, and economic and other reasons (Braverman et al., 2010).  An adequate response in resolving this problem has been elusive.  Healthy People (2010) have its goal improved access to comprehensive, high quality health care services.  The reason for this goal lies in the fact that the Federal government believes that fulfilling this goal is important to eliminate health disparities and increase the quality in years of healthy life for everyone in the United States (AHRQ, 2010).  According to the CDC (2010), the percentage of adults aged 18-64 years who lacked coverage at the time of interview increased from 18.9% in 1997 to 21.5% in early 2010.  The benefits to regular health care include integrated and accessible care, by health care providers in a sustainable manner. Some studies have documented that Hispanics and African Americans utilize health services less than their counterparts.  Much of the underutilization has translated into higher mortality rates for cancer and cardiovascular disease (Ashton et al., 2003)..

According to the March of Dimes (2009), “one in five women (12.4 million) of childbearing age was uninsured in 2008. Devoe, J.E., Tillotson, C.J., Wallace, L.S. (2009) study demonstrated that uninsured children had the highest rates of unmet needs overall, with fewer differences based on parental insurance status.  Woods (2003) study concluded that “fifty-five percent of children who live in single-parent, mother -only families are poor compared to 10% of children in 2 parent families” (p.708).  According to the National Women’s Law Center (2011), Female headed households had a very hard time in 2010 and it has not improved in 2011 due to the loss of jobs and consistent unemployment. Poor children often lack adequate health care and follow up for medical problems, and make more emergency room visits. Flores and Tomany-Korman (2008) concluded that African American children had more health disparities than their counterparts and these included the ability to concentrate, emotional problem and asthmatic diseases.  Concurrently, The Institute of Medicine (2009) reported that uninsured adults who are chronically ill will delay getting needed medications and visits to doctor, they will also be diagnosed with cancers at a later stage and have poorer outcomes for chronic diseases such as heart disease, lung disease, cancer , diabetes and other serious illnesses. The mortality rate is also higher.  A study by Hargreaves and Hadley (2003), revealed findings that African Americans were more likely than Hispanics to lack a regular health provider or seen a doctor. There is evidence in the literature that shows that this has an influence on health outcomes and this is especially significant for a population that is dealing with many health disparities. A study that highlights this issue was done by Asplin et al. (2005) in which findings revealed that insurance status was an important factor that influenced access to appointment follow ups for patients that would require emergency follow up care. Poverty in addition to other factors such as uninsurance and unemployment are stressors to families. In addition to affecting health lack of insurance certainly impacts the ability of mothers to follow up on immunizations for the children which could result in serious diseases if exposed.   Hoffman and Paradise (2008) stated “the consequences of inadequate access to care can spiral downward, resulting in poorer health and even disability , further jeopardizing  a family’s income and financial security” (p.151). The evidence has shown that there is a correlation between uninsurance, morbidity and mortality.

References

Ashton, C.M., Haidet, P., Paterniti, D.A., Collins, T.C., Gordon, H.S., O’Malley, K., Petersen, L.A., Sharp, B.F., Suarez-Almazar, M.E., Wray, N.P., Street, R.L. (2003). Racial and ethnic disparities in the use of health services: Bias preferences or poor communication? Journal of General Internal Medicine, 18, 146-152.

Asplin, B.R., Rhodes, K.V., Levy, H., Lurie, N., Crain, A.L., Carlin, B.P. & Kellerman, A.L. (2005). Insurance status and access to urgent ambulatory care follow-up appointments. Journal of American Medical Association (JAMA), 294(10), 1248-1254.

Bradley, J.C., Neumark, D., Shickle, L.M.and Farrel,N. (2008). Difference in breast cancer diagnosis and treatment :Experiences of insured and uninsured women in a safety-net setting. Inquiry, 45, 323-339.

Braverman, P.A., Cubbin, C., Egerter, S., Williams, D.R., & Pamuk, E. (2010). Socioeconomic disparities in health in the United States: What the pattern tell us. American Journal of Public Health, 100(S1), S186-S196.

Centers for Disease Control and Prevention (CDC, 2010). Percentage of persons of all ages without health insurance coverage at the time of interview: United States 1997-2010. Retrieved on November 3, 2010 from http://www.cdc.gov/nchs/data/nhis/earlyrelease/201009-01-pdf.

Centers for Disease Control and Prevention (CDC, 2010). Access to healthcare. Retrieved September 2011 from  http://www.cdc.gov/VitalSigns/pdf/2010-11-vitalsigns.pdf.

Devoe, J.E., Tillotson, C.J. and Wallace, L.S. (  2009). Children’s receipt of health care services and family health insurance patterns. Annals of Family medicine, 7, 406 -413.

Flores, G. and Tomany-Korman, S.C. (2008). Racial and ethnic disparities in medical and dental health, access to care and use of services in US children. Pediatrics, 121, e286-e297.

Hargraves, J.L. (2004). Trends in health insurance coverage and access among Black, Latino and White Americans, 2001-2003. The Community Tracking Study, 11, 1-4.

Hoffman,C. and Paradise, J(2008). Health insurance and access to health care in the United States. Annals of N.Y Academy of Science, 1136, 149-160.

Institute of Medicine (2009).America’s uninsured crisis: Consequences for health and health care. Retrieved from www.iom/edu/americasuninsuredcrisis.

March of  Dimes. (2009). Census data uninsured women and children September 2009. Retrieved from marchofdimes.com.

Marshall, M.N. (1996). Sampling for qualitative research. Family Practice, 13, 522-525.

National Women’s Law Center (2011). State poverty numbers reveal bleak situation for women and their families. Retrieved from http://www.nwlc.org.

O’Malley, A.S., Forrest, C. and O’Malley,P.G. (2000). Low-income women’s priorities for primary care. The Journal of Family Practice, 49(2), 141-146.

Patton, M.Q. (2002). Qualitative research & evaluation methods. (3rd ed.). Thousand Oaks, CA: Sage Publications Inc.

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