Two fellow AHCJ core topic leaders, Susan Heavey and Joseph Burns, have looked at aspects of the recent census report that documents a sharp decline in the uninsured rate. (Susan’s look at poverty and gender is here and Joe’s overview is here).
When the U.S. Census Bureau released its annual estimate of income, poverty and health insurance coverage this month, health insurance numbers were front and center. While family finances and the nation’s official poverty rate was stagnant last year, the numbers of those lacking coverage fell. Now newly released regional data offers a chance to tell more layered stories.
The overall findings, which cover 2014, offered a snapshot of how people in the United States are faring amid the first full year that the Affordable Care Act required most people to obtain health insurance coverage or face penalties. It also showed how many are still failing to see gains years after the recession officially ended.
The health care gains clearly stood out in the coverage of the findings from Census, which released its main report on Sept. 16. But peel back the layers and other interesting trends also emerged. One particularly interesting finding was that more women had health insurance last year than men. Continue reading
It’s about that time.
If you’ve been covering social determinants for a while, you’ve likely familiarized with the U.S. Census Bureau’s annual release of income, poverty and health insurance coverage data. If you’re new to health disparities, welcome to an annual rite.
Although the statistics measure the previous calendar year, they can provide a useful overall picture of how the United States is faring when it comes to income inequality, as well as access to health care. The figure is considered the nation’s official poverty rate.
New Census Bureau numbers forecast that there will be more older people in the United States than previously anticipated.
As Adele Hayutin of the Stanford Center on Longevity points out, the implications are big:
Some of the most important personal decisions that will be affected include choices about work, living arrangements, caregiving for older relatives and financial matters concerning retirement. Policymakers will need to consider how the faster pace of aging further threatens the financial viability of Social Security and Medicare.
The trend means that the financial burder of Social Security and Medicare will fall on a smaller “working-age population.”
Hayutin’s post explains the trends that account for the shift.
- Tip sheet: Using Census data for health reporting
Time to add another link to your “federal data clearinghouses” folder, if you haven’t already. Childstats.gov, published by the Federal Interagency Forum on Child and Family Statistics, synthesizes data from the CDC, NCHS, National Children’s Survey, AHRQ, Census and other specialized programs.
The site is anchored by its annual report, “America’s Children: Key National Indicators of Well-Being,” and the easy-to-navigate nature of its databases seems to have already inspired some discussion on Twitter, particularly in relation to child homelessness.
Many of the data tools are simply links to general surveys (like AHRQ’s National Healthcare Cost and Utilization Project) that just happen to contain child-related information, but there are some more specifically relevant data sources, the best of which I’ve listed below.
On Feb. 17, rankings of the relative health of counties in each American state were released by the Robert Wood Johnson Foundation and the University of Wisconsin. The rankings used data from 13 distinct (mostly federal) sources, including the National Center for Health Statistics, the Census Bureau and the Dartmouth Atlas. With that data, researchers computed eight separate composite scores, which were then weighted to produce one overall score. The ratings are navigated by clicking through a national map to the state and county level. Enough clicks will even bring you to the raw data itself. The state only compares counties, not states, because data collection varies from state to state and isn’t always standardized.
It’s a combination of data, analysis and an intuitive interface, and journalists have been quick to localize the story. Many reporters reached beyond the easy numbers (“our county is 67th!”) to use the system for deeper stories.
For example, Robin Erb of the Detroit Free Press dissected the ratings process and how individual factors and disparities played into them before launching into the standard state breakdown.
Writing for Health News Florida, David Gulliver took a broader state view and considered how various socioeconomic factors played into the rankings of Florida counties. Gulliver’s analysis:
The strong-performing coastal counties, like Collier, St. John’s Sarasota, Charlotte, Palm Beach and Broward, all benefit from having heavy concentrations of retirees who have guaranteed health care access via Medicare. …
[Dr. Kevin Sherin, director of public health for Orange County] said that in Florida’s tourism and service industries, workers tend to be transient and less likely to have insurance or consistent primary care.
He noted the low-ranked counties were some of the poorest in Florida, like Union and Bradford in the rural north, and Glades and Okeechobee, with heavy populations of migrant workers. Those counties also tend to have more people who speak only Spanish, Creole or other languages.
Gulliver localized the story on a county level for his Sarasota Health News site.
In USA Today, Mary Brophy Marcus took the national view and looked for broad trends and generalizations. Marcus’ story was accompanied by a map by Frank Pompa highlighting each state’s healthiest and least healthy counties.
The Census Bureau couldn’t have timed the release of its first American Community Survey data on health insurance coverage in America any better. Special interests and politicians alike have seized upon the data, and a wide variety of outlets have published analyses. NPR’s map breaking down coverage by state and political district is particularly interesting (To see other ACS results as well, try USA Today‘s map).
In case you somehow missed the coverage, here are a few highlights from the data:
- Fewest insured, overall: Texas (24.11 percent), New Mexico (21.44 percent), Nevada (21.33 percent), Florida (20.83 percent), Alaska (20.05 percent)
- Most covered, overall: Massachusetts (95.88 percent), Hawaii (93.28 percent), District of Columbia (91.95 percent), Puerto Rico (91.39 percent), Minnesota (91.33 percent)
- Under-18: Nevada, Texas and Arizona insure the fewest children, Massachusetts, Vermont and D.C. insure the most.
- Medicare: New Mexico, Texas, D.C., Arizona and California had the most uninsured folks over the age of 65. They also have some of the nation’s highest percentages of illegal immigrants.
If you’re still looking for local data, visit this page of the Census Bureau’s American FactFinder, sort by state, county, district or other census designation, and pull up the relevant data. When the data comes up, choose “Print/Download” from the top menu, choose “Download” and choose to save it in Excel format. From there, the data’s fairly easy to clean and use, though the more detailed levels (such as county) may require a little tweaking.
In their “The Cost of Care” package, Dallas Morning News reporters seek to explain why, as Jim Landers says in the lead of a key story, one of the nation’s largest cities is “broken market where doctors, hospitals and other providers shower patients with services of diminishing value but staggering cost.”
The problems are clear: The Dartmouth Atlas ranks Dallas as the 13th priciest health market in the nation, while new Census data gives Texans the dubious honor of living in the least-insured state in the nation. The whys and hows of these issues are trickier, but the Morning News wades into the health spending morass.
Jim Landers explores the paradox that health care in the city is expensive because there’s so much competition, and considers the contributions marketing and medical records make to health care costs. The piece includes an interesting profile of CIGNA regional president David Toomey’s attempts to rein in costs in the area.
Robert Garrett and Jason Roberson explain how everybody pays the price for the area’s super-low insurance coverage rates, and put an exact cost estimate, both financial and human, on the price of a high uninsured population.
Doctor-owned hospitals a lucrative practice, though opinions split on benefits
Gary Jacobson’s weighs the costs and benefits, both economic and medical, of doctor-owned hospitals, which are more common in Dallas than any other major metropolitan area.
Medical imaging a growth industry, but some say unneeded scans increase expenses
Ryan McNeill assesses just how useful the high-speed, unregulated growth of medical imaging has been for patients, doctors, investors and other stakeholders.
Critics see home health care boom as wasteful, but others tout benefits
When you’re looking to explain growing costs, it makes sense to focus your efforts on growing sectors, and Gregg Jones does just that, looking at the fast-growing home health sector. He leads with Medicare fraud, but then shows just how much deeper and more complicated the cost equation of home health care can get.