Skip to Content

Cost as a Barrier to Care

Lack of health insurance is one barrier to accessing health care, but even people who do have health insurance sometimes delay care because cost is a barrier. Delays in needed care increase the risk of diagnosing diseases at a later stage, disrupt management of diseases and conditions, and can lead to preventable hospitalizations (HP 2020 Access).

Findings in Santa Barbara County

Measure

Cost as a barrier to health care was based on the following question: “Was there a time in the past 12 months when you needed to see a doctor, but could not because of cost?” In addition to cost, other barriers to care were assessed with the following question: “During the past 12 months, did you delay or not get medical care you felt you needed— such as seeing a doctor, a specialist, or other health professional?”

Of all survey respondents, 19.1% answered yes to this question. This is a more accurate comparison to the HP 2020 Target, which assesses the percentage of people “unable to obtain or delayed in obtaining necessary medical care."

Table 15. Percentage of Adults Who Did Not Receive Health Care Because of Cost and Healthy People 2020 Target

2016 Santa Barbara
BRFSS
California*Health People 2020
Target
%(95% CI) % (95% CI)
Overall 6.9 (5.3 -8.5) 13.5 (12.6–14.5)
Male 6.9 (4.3-9.5) 11.6 (10.4–12.9)
Female 6.9 (4.9-8.9) 15.3 (13.9–16.6)
4.2**
Hispanic 7.0 (4.3-9.7) 19.5 (17.6–21.3)
Non-Hispanic White 7.7 (5.4-10.0) 9.0 (8.0–10.0)
Other NA NA

*2014 Behavioral Risk Factor Surveillance System
**Target slightly different than data presented: "Unable to obtain or delayed in obtaining necessary medical care."
NA = Not Available; estimates derived from fewer than 50 respondents were suppressed due to unreliability of the estimates.

Figure 44. Percentage of Adults Who Did Not Receive Health Care Because of Cost in Santa Barbara County, by Age and Sex

Percentage of Adults Who Did Not Receive Health Care Because of Cost in Santa Barbara County, by Age and SexClick to Enlarge

Figure 45. Percentage of Adults Who Did Not Receive Health Care Because of Cost in Santa Barbara County, by Race/Ethnicity, Educational Attainment, and Income

Percentage of Adults Who Did Not Receive Health Care Because of Cost in Santa Barbara County, by Race/Ethnicity, Educational Attainment, and Income Click to Enlarge

Health Disparities

The goal for HP 2020 is to reduce the percent of adults who did not receive needed health care to 4.2%. Adults in California failed to receive health care due to cost at 3 times this rate, whereas 6.9% of Santa Barbara County adults report not receiving health care because of the cost. This rate is relatively consistent across gender and age. However, there are disparities in care by age, educational attainment and income.

Factors and Health Outcomes Associated with Cost Barriers to Care

Figure 50 presents various individual, social, and environmental factors associated with cost barriers to care for people with such barriers, compared to all Santa Barbara County residents, and to Californians as a whole.

Figure 46. Health and Risk Factors of Adults in Santa Barbara County Who Did Not Receive Health Care Because of Cost (36.3%), Compared With All Santa Barbara County Adults and Californians* as a Whole

Health and Risk Factors of Adults in Santa Barbara Who Did Not Receive Health Care Because of Cost (36.3%), Compared With All Santa Barbara Adults and Californians* as a WholeClick to Enlarge

*Data for California are not available for all indicators

The chart shows that twice as many Santa Barbara County adults with cost barriers to care reported being in fair to poor health compared to the county and state as a whole. This is one of the few indicators associated with poor mental health: more than 30% of adults who did not receive care due to cost reported 15 or more days of poor mental health in the past 30 days. They also reported higher rates of housing and food insecurity, and a higher percentage was covered by Medicaid/Medi-Cal.

Key Opportunities for Population Health Improvement

What Businesses Can Do

What Healthcare Providers Can Do

What Individuals Can Do

  • Find out how much you might have to pay for care if you use different types of insurance plans.8
  • Access an affordable healthcare center,9 such as Santa Barbara Neighborhood Clinics10 or Santa Barbara County Public Health Department’s Health Care Centers.11

8 http://fairhealthconsumer.org/reimbursementseries.php?terms=cost-sharing-know-what-you-may-owe
9 https://findahealthcenter.hrsa.gov/?display=map&zip=Santa+Barbara+County&submit.x=0&submit.y=0
10 http://www.sbclinics.org/
11 http://cosb.countyofsb.org/phd/primarycare.aspx?id=19192

Population Health Listening Tour

Cottage Population Health Video - Santa Barbara

Learn about the challenges facing populations in Santa Barbara County and the implications that they have on public health.

Take the Tour

Connect With Pop Health

We want to hear from you -- our community leaders! E-mail the Population Health team at: listenpophealth@sbch.org, or to be added to our mailing list please fill out this brief form.

Mailing List Form

Cottage Health E-Living SignupCottage Health E-Living Newsletter

Sign up for Cottage Health’s FREE Health E-Living newsletter. This digital resource is full of events, healthy tips and nutritional information to help you on your wellness journey.

Listening Tour Findings

View a brief summary of key findings from the Cottage Population Health Listening Tour.

View Listening Tour Key Findings

Listening Tour Survey

The results from this survey helped Cottage Health prioritize the health indicators highlighted in the Community Health Needs Assessment (CHNA) report.

View Listening Tour Survey Results