Community Uninsurance and Unmet Health Care Needs: Is There a Spillover Effect for Rural Areas?

Michael Castro, Bowling Green State University

Providing comprehensive health insurance coverage is an important step towards improving population health. Research suggests that high community medical uninsurance creates a spillover effect for local healthcare systems that decrease overall healthcare access, although the relationship for rural areas is less clear. Using a sample of adults 18-64 in 2010 and 2011 (n=535,140) from the Behavioral Risk Factor Surveillance System (BRFSS) along with county-level estimates produced by the Census Bureau and the Health Resources and Services Administration, this study assesses how community-effects and rurality/urbanicity play an additional role towards predicting likelihood of experiencing an unmet need for health care in addition to individual characteristics. Research suggests that the spillover effect of community uninsurance increases likelihood of experiencing unmet need for the insured but not for the uninsured. Findings from this study will provide insight into the difficulties that may be encountered during the implementation of the Affordable Care Act (ACA).