Insurance Status
Having health insurance is a particular measure of a person’s ability to access health care. People without health insurance are less likely to have a usual source of health care and are more likely to miss routine medical visits, which can identify serious health conditions early or even prevent them entirely.
People with chronic diseases such as diabetes and hypertension need regular care to control their conditions, so lack of insurance can exacerbate these conditions. In addition, those without health insurance may struggle with large medical bills and out-of-pocket expenses (HP 2020 Access).
Findings in Santa Barbara County
Measure
Having health insurance was based on responses to the question: “Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, government plans such as Medicare or Medi-Cal, or Indian Health Service?”
In the Santa Barbara County survey, an answer of “no” was followed up for confirmation with “It appears that you do not currently have any health insurance coverage to help pay for services from hospitals, doctors, and other health professionals. Is that correct?”
Table 13. Percentage of Adults With Health Insurance and Healthy People 2020 Target
| 2016 Santa Barbara
BRFSS | California* | Health People 2020
Target |
|---|
|
%(95% CI) |
% (95% CI) |
|---|
| Overall |
88.7 (86.6–90.9) |
85.2 (84.2–86.2) |
|---|
| Male |
84.7 (81.0–88.3) |
83.8 (82.3–85.3) |
|---|
| Female |
92.5 (90.4–94.9) |
86.5 (85.1–87.8) |
|---|
|
|
|
100.0 |
|---|
| Hispanic |
76.1 (71.4–80.8) |
71.4 (69.2–73.6) |
|---|
| Non-Hispanic White |
97.2 (95.7–98.6) |
93.1 (92.2–94.1) |
|---|
| Other |
94.6 (90.0–99.2) |
NA |
|---|
*2014 Behavioral Risk Factor Surveillance System.
Figure 36. Percentage of Adults With Health Insurance Coverage in Santa Barbara County, by Sex and Age
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Figure 37. Percentage of Adults With Health Insurance Coverage in Santa Barbara County by Race/Ethnicity, Educational Attainment, and Income
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Health Care Coverage for Children and Health Disparities
The questionnaire asked adult respondents about whether their child has any kind of health care coverage. Overall, 95.9% of adults reported health care coverage for children in their care. With such a high rate of coverage overall, there were fewer marked disparities by demographic group; regardless of ethnicity, educational attainment, or income level, no group reported a coverage rate for children of less than 94%.
Some groups, including adults with a college degree and those with incomes of at least $75,000, reported health care coverage rates for children above 99%.
Health Care Coverage for Adults and Health Disparities
A notably smaller percentage of people with the lowest level of educational attainment (less than a high school degree) and in the lowest income category had health insurance, possibly because they work in jobs that do not provide it or cannot afford the employee contribution to the premium, if they are working at all.
In addition, a smaller proportion of men than women are insured, and neither group meets the Healthy People 2020 target of 100% insured. Only about three-fourths of Hispanic people have insurance in Santa Barbara County, compared to almost all white people.
Figure 38. Percentage of Santa Barbara County Adults Without Any Kind of Health Care Coverage, by County Subregion
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Factors and Health Outcomes Associated With a Lack of Health Insurance
Figure 39 presents various individual, social, and environmental factors that relate to having health insurance or not. It compares survey respondents without health insurance to all adults in the Santa Barbara County survey and to Californians as a whole.
Figure 39. Health and Risk Factors of Adults in Santa Barbara County With No Health Insurance (11.3%), Compared With All Santa Barbara County Adults and Californians* as a Whole
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*Data for California are not available for all indicators
The chart shows that people without health insurance are more likely than others in Santa Barbara County to report only fair or poor health, to report binge drinking, and to experience both housing and food insecurity. The percentage of people who have heart disease and diabetes and who are uninsured is small, because the largest group of uninsured people is also the youngest group, who tend to have no heart disease. They are less likely to have a high school degree and a personal health care provider than others in Santa Barbara County and in California as a whole.
Key Opportunities for Population Health Improvement
What Businesses Can Do
What Healthcare Providers Can Do
What Individuals Can Do
