Studying the Mississippi Uninsured: Utilizing self-reported data to assess subpopulation access and out-of-pocket accessibility

Purpose: Over 1 in 5 Mississippi adults has no kind of health insurance coverage. Lack of accessibility contributes to poor health outcomes. This study assesses uninsured prevalence by socioeconomic indicator and also assesses cost as a self-reported barrier to seeking medical care.

Methods: Data were obtained from the 2013 Mississippi BRFSS to compare health plan coverage by race, gender, income, and educational level. To evaluate these comparisons, Chi-square tests were performed using SAS 9.3.

Results: By race, 33.4% of blacks (vs. 22.6% of whites, p<.001) are uninsured. By gender, 29.2% of males (vs. 27.1% of females, p<.001) are uninsured. 45.9% of annual household incomes less than $20,000 are uninsured. This prevalence decreases as household income increases (p<.001).  47.4% of those with less than a high school education are uninsured. This prevalence decreases as attained education increases (p<.001). Of those who needed to see a doctor within the past 12 months but were unable due to cost, 56.6% are uninsured (vs. 43.4% of those with coverage, p<.001).

Conclusion: Uninsured Mississippi adults are disproportionately represented by blacks, males, and those with less education and household income. Of particular note is that over 43% of Mississippi adults are unable to see a doctor due to costs, even though they are insured.  This study can be beneficial to Mississippi policy makers and advocates, as they study the effectiveness of the Affordable Care Act, lack of Medicaid expansion, and need for continued policy reform.