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Almost 1 in 5 Americans Going Without Health Care

Money, availability of care and lack of transportation combine to limit access, CDC report finds

MONDAY, Dec. 3 (HealthDay News) -- Almost 20 percent of Americans, or more than 40 million adults, can't afford or access needed health care, according to a new U.S. government report released Monday.

Access to health care is the focus of this year's Health, United States, 2007 report from the Centers for Disease Control and Prevention (CDC). It shows that one-fifth of Americans couldn't afford one or more of these services: medical care, prescription medicines, mental health care, dental care, or eyeglasses.

"People tend to equate access to care with insurance," said report author Amy Bernstein, chief of the analytic studies branch at the CDC's National Center for Health Statistics. "But access to care is more than insurance."

"People assume that if you have health insurance of any kind that you're okay, but that's not the case," she added.

Among the other barriers are locales without enough doctors, lack of transportation to doctors and clinics, and shortages of such organs as kidneys for transplants.

That means that even when people "have health insurance there are still disparities," Bernstein said.

In 2005, almost one in 10 people aged 18 to 64 years old reported not being able to afford prescription drugs and almost 10 percent said they postponed getting the medical care they needed.

While it's not the only factor, a lack of health insurance remains a key to accessing care, Bernstein said.

"We have a lot of evidence that people who don't have health insurance are much less likely to receive services than people who do," she said. "Health insurance is critical."

Other findings in the annual report:

  • About 30 percent of young adults 18 to 24 do not have a usual source of medical care, and 30 percent have no health insurance.
  • Among adults 45-64, one in 10 lacks a usual source of health care. In this group, about one in every 20 has high blood pressure, a serious heart condition or diabetes but no usual source of medical care.
  • In 2005, one out of five people under 65 said they had been uninsured for at least some part of the past year. Most in this group said they had gone without insurance for more than 12 months.
  • About 10 percent of women aged 45 to 64 with incomes below the poverty line reported delaying medical care because of a lack of transportation.
  • About one-third of children living below the poverty level didn't see a dentist in 2005, compared with fewer than one fifth of children in higher-income families.

Despite these problems, there were some gains, the report noted.

Last year, 87 percent of young children between 19months and 35 months old were vaccinated against bacterial meningitis, up from 41 percent in 2002.

Moreover, the percentage of adults with high cholesterol dropped, to 17 percent, down from 21 percent between 1988-1994.

Also, 25 percent of adults had untreated cavities in 2004, down from 50 percent in the early 1970s, the report said.

"There has been important progress made in many areas of health, such as increased life expectancy, and decreases in deaths from leading killers such as heart disease and cancer. But this report shows that access to health care is still an issue where we need improvement," CDC Director Julie Gerberding said in a prepared statement.

One expert believes the answer to the problem lies in a universal national health care system.

"It's scandalous that so many people in this country couldn't get needed health care," said Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and a co-founder of Physicians for a National Health Program.

This is not only a problem for people who are uninsured, Woolhandler said.

"It's common that people have insurance, but because of gaps in their coverage like co-payments, deductibles and uncovered services, people report that they needed but couldn't get health care," she added.

More information

You can read the full report at the CDC.

SOURCES: Amy Bernstein, Sc.D., chief, analytic studies branch, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Md.; Steffie Woolhandler, M.D., associate professor, medicine, Harvard Medical School, Boston, and co-founder, Physicians for a National Health Program; Dec. 3, 2007, CDC report Health, United States, 2007

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