Does General, Physical and Mental Health Differ by Healthcare Coverage or Healthcare Cost for Middle-Aged Females?

Purpose: Research linking health status and healthcare access does not clearly establish the relative impact of healthcare coverage versus healthcare cost for health status outcomes, especially for middle-aged women. Therefore, the purpose of this study was to determine whether general, physical, and mental health status outcomes differed by healthcare coverage or healthcare cost in multiple samples of middle-aged females.
Methods: This cross-sectional analysis used 2015 data from the Behavioral Risk Factor Surveillance System (BRFSS) for females aged 35-54 from Alabama, Arkansas, Louisiana, and Mississippi. To establish patterns in relations, multiple logistic regression analysis by state assessed the relationships separately for general health, mental health, and physical health with healthcare coverage and healthcare cost while controlling for other health and demographic factors.
Results: Most participants reported good general health status (73-79%), and about half reported good physical health status (54-59%) and good mental health status (54-58%) despite also reporting two or more health conditions (47-53%). In addition, most participants reported having healthcare coverage (82-92%) and not having cost preclude doctors’ visits (74-82%). The results of adjusted analysis indicated that good general, mental, and physical health status outcomes were inversely related to healthcare cost in three of four states and to two or more health conditions in all four states. In addition, good general health status and physical health status were related positively to income level in 3 of 4 states.
Conclusion: Overall, general, physical, and mental health status outcomes in middle aged women showed consistent patterns of relations with healthcare cost across similar samples, but not to healthcare coverage. In addition, all three health status outcomes were related to multiple health conditions, and general and physical health were related to income level. Although this study lacked specific information for healthcare concerns and costs for middleaged women, providers and policy makers should consider the costs of health management for middle-aged female patients, especially in low income areas.


Gilchrist DN, Wrzesinski LD, Schultz BJ, Samuels KL, Hartos JL

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