Gender-specific Health Services And Health Insurance: European Approaches – Michelle Long, Brittni Frederiksen, Usha Ranji, Alina Salganicoff Follow @a_salganicoff on Twitter and Karen Diep
Women’s access to health care is shaped by a wide range of factors, including coverage and income, the availability of health care providers in their communities, and the affordability of care and health insurance.
Gender-specific Health Services And Health Insurance: European Approaches
The Affordable Care Act (ACA) expanded pathways to affordable coverage for millions of women by expanding Medicaid eligibility and providing subsidies to make individual health insurance more affordable for those who do not have access to coverage through their employer. The ACA also contains provisions aimed at easing some financial barriers to health care; however, many women still face challenges with health care costs and medical bills, especially those who are uninsured or have low incomes.
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This report presents findings from the 2022 Women’s Health Survey (WHS) on women’s health status, health service use and costs. The WHS is a nationally representative survey of 5,145 self-identified women aged 18 to 64, conducted from May 10 to June 7, 2022. See Methodology for more details.
Health Status and Prescription Drug Use Health Status Most women ages 18 to 64 report being in fair or excellent health, but a significant proportion of low-income women and those with Medicaid describe their health as fair or poor.
The majority of women aged 18 to 64 (82%) rate their health as excellent, very good or good; however, 18% of women describe their health as good or poor, similar to other national estimates.
A higher proportion of women aged 36 to 49 (20%) and aged 50 to 64 (19%) rate their health as good or bad than those aged 18 to 35 (16%) (Figure 1). A higher proportion of black (22%) and Hispanic (20%) women report being in good or poor health than white (16%) and Asian/Pacific Islander (13%) women. (People of Hispanic origin can be of any race; the other groups are non-Hispanic.) About three in ten low-income women (28%) and women with Medicaid coverage (30%) rate their health as good or poor. (This survey defines low income as household income below 200% of the Federal Poverty Level (FPL); higher income is 200% or more of the FPL. The Federal Poverty Level (FPL) for an individual in 2022 is $13,590.) A higher share of women with Medicaid describe their health as good or poor than women with employer-sponsored insurance (11%), individual insurance (13%), and the uninsured (23%).
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Half (49%) of women aged 18 to 64 report having a permanent health condition that requires regular monitoring, medical care or medication (Figure 2). This rate increases with age, from 41% of women aged 18-49 to 65% of women aged 50-64. A lower proportion of Hispanic (41%) and Asian/Pacific Islander (38%) women report having a persistent health condition than white (52%) and black (49%) women. More women with employer-sponsored insurance (46%) report having a permanent health condition that requires regular care than uninsured women (36%). Women with Medicaid (53%) are more likely to report a permanent condition than those with employer-sponsored insurance or the uninsured.
Eighteen percent of women aged 18 to 64 report having a disability or chronic illness that prevents them from fully participating in work, school, housework, or other activities (Figure 3). Women aged 50 to 64 are more likely to report a disability or chronic illness than those aged 18 to 49 (24% vs. 15%). Lower proportions of Hispanic women (14%) and Asian/Pacific Islander women (6%) have a limiting disability or chronic condition than white (18%) and black (22%) women. Women with Medicaid coverage (30%) and those with low incomes (29%) are more likely than their counterparts to report having a disability or chronic illness.
Prescription Drug Use Nearly two-thirds of women ages 18 to 64 regularly take at least one prescription drug, including birth control pills.
Women may take prescription drugs to treat or manage chronic conditions and acute illnesses or to prevent pregnancy. Sixty-three percent of women reported taking at least one prescription drug regularly, including birth control pills (Figure 4).
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Prescription drug use increases with age, with 58% of women aged 18-49 taking at least one regularly compared to 73% of women aged 50-64. White women (68%) are more likely than Asian/Pacific Islander women (49%), Hispanic women (55%) and Black women (58%) to take prescription drugs regularly. As might be expected, a higher proportion of women in fair or poor health reported taking prescription drugs regularly than women in excellent or very good health (76% vs. 54%). Although more uninsured women (23%) rate their health as good or poor than insured women (17%), a higher proportion of insured women (65%) (data not shown) report taking prescription drugs than uninsured women (43). %). One explanation for this could be that uninsured women have less access to health care and affordable drugs than those with insurance, which could result in less prescription drug use.
Differences between women and men In measures of health status and prescription drug use, there are some differences and some similarities between women and men.
More women than men reported having a persistent medical condition that required regular monitoring, medical care, or medication (49% vs. 43%) or regularly taking at least one prescription drug (63% vs. 48%) (Figure 5). . There is a similar share of women and men who rate their health condition as good or bad (18% and 20%, respectively), as well as the share of those who state that they have a disability or a chronic illness that prevents them from fully participating in work, school, household chores or other activities (18% and 17% respectively). (These questions were asked of people of all genders, including non-binary people; however, there is insufficient data to report on non-cisgender people.)
Access to Health Care Sources While the vast majority of women have a regular provider they go to for routine care, only half of uninsured women have a regular source of care.
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Having a usual source of health care is associated with increased use of preventive care and better health outcomes. Eighty-two percent of women have a regular doctor or health care provider they see when they are sick or need routine care. The share of women who have a regular service provider increases with age (Figure 6). Hispanic women (79%) are slightly less likely than white (83%) and black (84%) women to have a usual source of care. Fewer uninsured women (52%) and low-income women (79%) reported having a usual source of care than their counterparts. Women living in a state that expanded Medicaid were more likely to have a usual source of care than women in states that did not expand Medicaid (83% vs. 79%) (data not shown). Ten percent of women with disabilities or chronic health problems do not have a regular doctor or health care provider (data not shown).
Places of Care Most women get their health care in doctor’s offices, but health centers and clinics are common places of care for underserved communities, especially uninsured women, those with Medicaid, and Hispanic women.
Eighty-two percent of women have a regular doctor or a place where they usually go for health care. Among them, eight out of ten (79%) stated that they usually receive care at a doctor’s office (Figure 7). Ten percent receive care at an urgent care or retail clinic; 8% usually go to a health center or school clinic; and 3% list the emergency room or another place as their usual place of care.
More women aged 50 to 64 (88%), white (84%) and Asian/Pacific Islander women (83%), higher-income women (85%) and those with private health insurance (86%) rely to the doctor’s office for their regular care than their colleagues (Table 1). (Private health insurance includes employer-sponsored insurance and individually purchased insurance.) Health centers and clinics play a greater role as places of care for women aged 18-49 (10), Hispanic women (19), low-income women ( 15%), those with Medicaid (17%), and uninsured women (25%) than their counterparts.
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Regular doctor visits give people the opportunity to talk with clinicians about a wide range of issues, including disease prevention, the role of lifestyle factors on health, and chronic disease management. Under the Affordable Care Act, most health plans must cover at least one annual exam/visit for a woman, which can include nutrition and physical activity assessments, prenatal care, and cancer screenings.
In general, women have more interactions and connections with the health care system than men. A higher proportion of women than men report having a usual source of care and having visited a health care provider in the past two years.
Women are more likely than men to report having a regular place of care (87% vs. 77%) and a regular doctor or health care provider (82% vs. 71%) (Figure 8). Ninety-five percent of women said they had seen a doctor in the past two years, and among them 77% had a check-up, compared to 88% and 72% of men, respectively. (These questions were asked of people of all genders, including non-binary people; however, there is insufficient data to
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