Women and Health Care: A National Profile

Transcription

1 Women and Health Care: A National Profile Alina Salganicoff, PhD Vice President and Director, Women s Health Policy Kaiser Family Foundation July 7, 2005 Washington DC

2 Figure 1 The Kaiser Women s Health Survey Nationally representative sample of 2,766 women 18 and older; comparison sample of 507 men 25 minute telephone interviews conducted July 6 to September 26,2004 Oversample of African American, Latina, and low-income women to allow for analysis by race/ethnicity, poverty level, and insurance coverage Survey designed and analyzed by researchers from Kaiser Family Foundation, Princeton Survey Research Associates International, and UCLA

3 Figure 2 Selected Demographic Characteristics, Women Ages 18 and Older 65 and older 17% 55 to 64 13% 45 to 54 19% Other 5% White 71% Unknown 17% 300% to 399% of poverty 37% College Graduate 24% Post High School 27% 25 to 44 38% 16% 33% 100% to 199% of poverty 20% 18 to 24 12% Age Group Latina 12% African American 12% Race/ Ethnicity 200% to 299% of poverty <100% of poverty 11% Poverty Level High School High school incomplete 15% Education Includes Asian, Pacific Islander, American Indian, Alaska Native, people of multiple races, and those who identified themselves as other.

4 Women s Health Status

5 Figure 3 Self Reported Health Status, Women and Men Ages 18 and Older Fair/Poor health Disability/condition limiting activity 19% 21% 14% 13% Chronic condtion requiring ongoing treatment 30% 38% Arthritis Asthma/other respiratory 8% 17% 15% 26% Women Men Diabetes Heart disease 10% 8% 7% 10% Obesity 4% 13% Significantly different from Women, p <.05. Chronic conditions diagnosed by physician in past 5 years.

6 Figure 4 Health Status Indicators, by Age Group, Women Ages 18 and Older 18 to 44 59% 45 to and older 50% 31% 13% 23% 9% 18% 22% 23% Fair/Poor Health Significantly different from 45 to 64, p <.05 Have disability or condition that limits activity Have chronic condition that requires ongoing treatment

7 Figure 5 Depression and Anxiety, by Selected Factors, Women Ages 18 and Older Diagnosed with depression or anxiety in past five years by physician: Total Women Men 11% 23% Age Group 18 to to and older Race/ Ethnicity African American Latina White Poverty Level < 200% of poverty 200% of poverty or higher 16% 16% 23% 26% 23% 24% 20% 30% Note: 200% of poverty was $29,552 for a family of three in Significantly different from reference group (Women, 45 to 64, White, 200% of poverty or higher), p <.05.

8 Women s Coverage and Access to Care

9 Figure 6 Health Insurance Coverage, Women and Men Ages 18 to 64 6% 6% 3% 7% 8% 5% 29% 35% 13% 49% Other Medicaid Individually purchased Employer-sponsored, dependent Employer-sponsored, primary Uninsured 17% 20% Women Men Other includes Medicare, CHAMPUS, TRICARE, and unknown insurance.

10 Figure 7 Delayed or Went Without Care Because of Cost, by Insurance and Health Status, Women Ages 18 and Older Percent reporting they delayed or went without care they thought was needed in the past year due to costs: 67% 32% 37% 24% 17% 13% 21% All Women Private Medicaid Medicare Uninsured Insurance Status Excellent to good Fair/Poor Health Status Significantly different from reference group (Private, Excellent to good), p<.05.

11 Figure 8 Changes in Affordability as a Barrier to Care, by Insurance Status, 2001 and 2004, Women Ages 18 to 64 Percent reporting they delayed or went without care they thought was needed in past year due to costs: 59% 67% % 27% 13% 17% 29% 32% All women Private Medicaid Uninsured Significantly different from 2001, p<.05. Source: Kaiser Family Foundation, 2001, 2004 Kaiser Women s Health Surveys.

12 Figure 9 Reasons for Delaying or Going Without Care, by Poverty Level, Women Ages 18 and Older Percent reporting they delayed or went without care they thought was needed in the past 12 months due to: All Women 33% 27% Less than 200% of poverty 200% of poverty and higher 19% 12% 21% 19% 19% 18% 15% 13% 20% 17% 7% 8% 3% No insurance Couldn't find time Couldn't take time off work^ Child care problems^^ Transportation problems Note: 200% of the federal poverty threshold was $29,552 for a family of three in Significantly different from 200% of poverty and higher, p<.05. ^Among women who are employed. ^^ Among women with children younger than 18 years living in household.

13 Figure 10 Use of Prescription Drugs, by Selected Characteristics, Women Ages 18 and Older Percent reporting they use at least one prescription drug on a regular basis: Total Women Men 42% 56% Age Group 18 to to and Older 37% 70% 87% Race/Ethnicity African American Latina White Insurance Status Private Medicaid Medicare Uninsured 32% 31% 61% 53% 49% 54% 87% Significantly different from reference group (Women, 45 to 64, White, Private), p<.05.

14 Figure 11 Impact of Drug Costs, by Insurance Status, Women Ages 18 and Older Percent reporting that in the past year they: 41% All Women Private Medicaid Medicare Uninsured 26% 20% 19% 17% 15% 14% 13% 13% 10% 8% 5% 11% 12% 19% Did not fill prescription medicine due to costs Skipped or took smaller doses of prescription medicines to make them last longer Spent less on basic needs for family to pay for prescription medicines Significantly different from Private, p<.05.

15 Women s Health Care Experiences

16 Figure 12 Provider Counseling About Health Behaviors, Women Ages 18 and Older Percent of women reporting they have discussed topic with doctor or nurse in past 3 years: Diet, exercise, nutrition 55% Getting enough calcium to prevent bone loss 43% Smoking 33% Mental health issues 29% Alcohol or drug use 20%

17 Figure 13 Provider Counseling About Sexual Health, Women Ages 18 to 44 Percent of women reporting they have discussed topic with doctor or nurse in past 3 years: Sexual history 31% Sexually transmitted diseases 28% HIV/AIDS 31% Emergency contraception 14% Domestic or dating violence 12% Percent reporting they have ever discussed emergency contraception with a doctor or nurse.

18 Figure 14 Health Care Information Sources, Women Ages 18 and Older Percent of women reporting they turn to this source first when needing information on a particular health issue: Books 7% Other 9% Internet 15% Health care provider 53% Friends/family 16% Note: Other includes pharmacist and unknown sources, as well as no source identified.

19 Figure 15 Screening Tests, Women Ages 18 and Older Percent of women reporting they have received screening test in past two years: Blood pressure 89% Clinical breast exam Pap smear 75% 73% Mammogram 70% Blood cholesterol 62% Colon cancer 38% Osteoporosis 37% Note: Colon cancer screening among women 50 and older; osteoporosis screening among women 45 and older.

20 Figure 16 Changes in Mammography and Pap Smear Rates, 2001 and 2004, Women Ages 18 to 64 Percent screened in past two years: 73% 69% 81% 76% Mammograms Women Ages 40 to 64 Pap Smears Women Ages 18 to 64 Significantly different from 2001, p<.05. Source: Kaiser Family Foundation, 2001, 2004 Kaiser Women s Health Surveys.

21 Figure 17 Concerns About Quality of Care, by Selected Characteristics, Women Ages 18 and Older Percent reporting they had concerns about the quality of health care they received in the past year: Total Women 21% Age Group 18 to to and older Race/Ethnicity African American Latina White 12% 23% 21% 25% 18% 29% Health Status Excellent to Good Fair/Poor 18% 31% Significantly different from reference group (45 to 64, White, 200% of poverty and higher, Private, Excellent to Good). Note: 200% of the federal poverty threshold was $29,552 for a family of three in 2004.

22 Figure 18 Access to New Doctors, by Insurance Status, Women Ages 18 and Older Percent of women reporting they tried to see a new doctor in past year, but the doctor was not accepting new patients: Total All Women 13% Insurance Status Private 13% Medicaid 23% Medicare 7% Uninsured 18% Significantly different from private, p<.05.

23 Women and Family Health Care

24 Figure 19 Mothers Family Health Care Roles, Women Ages 18 and Older Percent who usually: 2% 1% 2% 18% 12% 3% 18% 1% 2% 5% 23% 15% Other Adult/Don't know/na Joint Responsibility Spouse/Partner 79% 84% 78% 57% Women Select child's doctor Take child to doctor's appointments Ensure child obtains recommended care Note: Among women with children under 18 in the household. Primarily Responsible for Decisions About Children s Health Insurance:

25 Figure 20 Caring for Sick and Disabled Family Members, Women Ages 18 and Older Percent of family caregivers reporting they provide assistance with: Housework, shopping, errands, meals, etc. 91% Transportation Finances (bills, insurance paperwork, financial decisions) 66% 83% Medical decisions (i.e. choosing doctor or nursing home) Medical care (i.e. insulin shots, taking medicines, adjusting equipment) Physical care (dressing, bathing, etc.) 42% 58% 65%

26 Figure 21 Caregiver Time Commitment, by Poverty Level, Women Ages 18 and Older Hours per week that family caregivers spend assisting sick/disabled relative: 4% 3% 2% 17% 29% 44% 30% DK/Refused 27% 22% 18% All Caregivers 24% 18% 10% Less than 200% of poverty 26% 25% 200% of poverty and higher More than 40 hours 11 to 40 hours 5 to 10 hours Fewer than 5 hours Note: 200% of the federal poverty threshold was $29,552 for a family of three in 2004.

27 Figure 22 Conclusions Women s health status, needs, and use of health care system evolve over their lives. Health coverage public or private matters for women. Health care costs increasingly pose a barrier to health care for many women. Limited reach of preventive care counseling and services. Women play a central role in their families health. Women who are poor, sick, minorities, or uninsured face many barriers and often have the poorest experiences with the system.