Depression, Access Barriers, and Their Combined Associations with Unmet Health Needs among Publicly Insured Individuals in Minnesota

Nathan D. Shippee, Kathleen Thiede Call, Whitney Weber, Timothy J. Beebe

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Studies have examined how individual risk factors affect unmet health needs, but few have assessed how factors combine to create compounded risk. Using administrative and survey data from 1,897 publicly insured individuals in Minnesota, this study examines how diagnosed depression—a condition with established functional morbidity—moderates the association between seven common access barriers (e.g., transportation problems, lack of child care, clinic hours) and self-reported unmet health needs. Depression and access barriers were independently, positively associated with unmet need. Depression moderated barriers’ effects: Number of barriers reported had a stronger association with unmet need for individuals with depression. Depressed individuals reporting all barriers had a 70 percent chance of unmet need. Subgroup differences for individual barriers suggest that depressed individuals’ utilization patterns and functional limitations may shape their reactions to access barriers. Findings may inform improvements in public benefit designs and target the unique vulnerabilities associated with depression.

Original languageEnglish (US)
Pages (from-to)85-98
Number of pages14
JournalSociety and Mental Health
Volume2
Issue number2
DOIs
StatePublished - 2012

Keywords

  • depression
  • poverty
  • risk factors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

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