The Greater Cincinnati Community Health Status Survey (CHSS) has found that minorities and the poor are more likely to report that not having insurance or their type of insurance is a barrier to finding a trusted health care provider.
"Research shows trust between a patient and provider is important for creating an effective care environment,” explains Greer Glazer, PhD, associate vice president for health affairs at the University of Cincinnati and dean of the UC College of Nursing. "Having trust in this relationship leads to increased patient satisfaction and better compliance with treatment recommendations,” she says.
Glazer is also co-principal investigator at Urban Universities for HEALTH (UU HEALTH) at UC. Interact for Health worked with UU HEALTH to create questions about lack and type of insurance and race and ethnicity as barriers to finding a trusted health care provider.
"As far as we know, this is the first time these questions have been asked on a regional health status poll; there is no national benchmark,” says Francie Wolgin, senior program officer, Protecting the Healthcare Safety Net, Interact for Health.
Lack and type of insurance as a barrier
About two in 10 adults (19 percent) in Greater Cincinnati report not having insurance or their type of health insurance as a barrier to finding a trusted health care provider.
"However, this issue is more of a barrier for some groups than others,” says Wolgin.
About 4 in 10 (37 percent) of those at 100 percent of the Federal Poverty Level (FPL) or below report not having insurance or their type of health insurance as a barrier to finding a trusted provider, compared to only 1 in 10 of those above 200 percent of FPL (13 percent).
"We also found that as age and education increase, that the percentage of adults reporting type of health insurance or lack of it a barrier decreases.”
African-American adults (26 percent) are more likely to report that not having health insurance or their type of insurance is a barrier than white adults (18 percent).
Race and ethnicity as a barrier
While only 4 percent of adults in the community overall report race/ethnicity as a barrier, the number varies dramatically among specific subgroups.
"African-Americans report race/ethnicity as a barrier more than twice as often as white Appalachians and non-white Appalachians, 8 percent versus 3 percent,” says Wolgin.
Other non-white groups report this barrier four times more frequently—with 12 percent saying race/ethnicity is a barrier.
"To us, this indicates a need for health care providers from a more diverse array of racial and ethnic groups, as well as a need for more culturally competent providers,” says Barbara Tobias, MD, professor at the UC College of Medicine, medical director of the Health Collaborative, a board member of Interact for Health, and co-principal investigator at UU HEALTH.
Race and ethnicity are also reported as barriers to finding a trusted health care provider more often among people living in poverty and among those who are uninsured. Respondents at 100 percent of the Federal Poverty Level and below reported this barrier five times as often as people living 200 percent and above the poverty level —10 percent versus 2 percent.
More information about insurance, race and ethnicity as barriers to finding a trusted provider and other topics, is available online at www.interactforhealth.org/greater-cincinnati-community-health-status-survey.
About the Greater Cincinnati Community Health Status Survey (CHSS)
The 2013 Greater Cincinnati Community Health Status Survey (CHSS) is conducted by the Institute for Policy Research at the University of Cincinnati. A total of 4,929 randomly selected adults residing in eight Ohio counties, nine Kentucky counties, and five Indiana counties were interviewed by telephone between August 20, 2013, and Jan. 19, 2014. This included 4,324 landline interviews and 605 cell phone interviews. The potential sampling error for the survey is ±1.5%.
About Interact for Health
Interact for Health, formerly The Health Foundation of Greater Cincinnati, improves the health of people in the Cincinnati region by being a catalyst for health and wellness. We accomplish our mission by promoting healthy living through grants, education and policy. Interact for Health is an independent nonprofit that serves 20 counties in Ohio, Kentucky and Indiana.