Does health insurance status affect health status for DC residents?
Thesis (M.P.P.)--Georgetown University, 2011.; Includes bibliographical references.; Text (Electronic thesis) in PDF format. Context: In this changing health insurance environment, it is important to understand the effects of different insurance programs on one's health status. The Affordable Care Act expands Medicaid substantially, though it has been shown previously to be associated with worse health statuses for its participants. This study looks at the pre-reform environment in the District of Columbia and provides insight into the changes being made.; Objective: To examine the effect of insurance status on two measures of health for residents of the District of Columbia.; Design, Setting, and Participants: the Urban Institute conducted The DC Health Insurance Study in 2009. They surveyed 4699 individuals on a variety of topics relating to health insurance, demographic characteristics and health status. The households in this survey were selected at random using two methodologies: random-digit dial telephone sample and an address-based random household sample.; Main Outcome Measures: The outcomes of interest are two measures of health status. The first is a self-reported status ranging from 1 (Poor or Fair) to 4 (Excellent). Individuals were asked to rate their health statuses on this scale. The second is a dummy variable indicating the presence of an activity limitation. Activity limitation is defined as a "physical, mental or emotional problem" that limits an individual in any way. These two measures are estimations for the individual's actual health status.; Results: The study finds that health insurance does not have a significant effect on health status. Medicare and Medicaid participants are significantly more likely to have an activity limitation than beneficiaries of other insurance and the uninsured. Instead, income, age, education and race all have significant effects on health status. The study finds that higher incomes and educational attainment are associated with higher health statuses. Furthermore, as expected, older individuals are more likely to be in poorer health than younger persons. Finally, minorities are significantly more likely to have worse health than their white counterparts.; Conclusions: The findings do not support the argument that policies increasing enrollment in health insurance will improve health status. Rather, the results suggest that policies intended to reduce income inequality, eliminate health disparities across racial lines and increase educational attainment would have greater effects on health status.
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