Access to Health Care in South Texas

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Access to Health Care in South Texas

dequate access to health care services, including preventive services and treatment for illnesses, is critical to achieving positive health outcomes. Two major limitations of adequate access to care are a lack of health insurance and a shortage of health care providers in certain areas.1

Lack of Health Insurance

Lack of health insurance coverage is a significant barrier to seeking and receiving health care.2,3 Nationwide, Hispanics and young adults ages 18-24 are more likely to be

uninsured than other demographic groups.1,2

Using Texas Behavioral Risk Factor Surveillance System (BRFSS) survey data, an estimated 33% of South Texas adults were uninsured during 2002-2005. South Texas had a higher percentage of uninsured residents than the rest of Texas. Both South Texas and the rest of Texas had a higher percentage of uninsured residents than the nationwide BRFSS estimate of about 16% (Figure 3.1). The estimated South Texas uninsured rate was twice as high as the national rate.

Figure 3.1. Estimated percent of the adult population (age 18 or older) with no health insurance

by location, 2002-2005.

Source: Estimated Prevalence using the Texas Behavioral Risk Factor Surveillance System Combined Year Dataset, Statewide BRFSS Survey, 2002-2005

Prevalence of No Health Insurance (Adults 18+), 2002-2005 0 5 10 15 20 25 30 35

South Texas Rest of Texas Nationwide

P e rc e nt

A

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In South Texas during 2002-2005, Hispanics and African-Americans had much higher percentages of uninsured individuals than did non-Hispanic whites. Hispanics had the highest uninsured rate of all race/ethnic groups; an estimated 46% of the Hispanic South Texas population had no health insurance. The percentage of Hispanics with no health care was three times as high as for non-Hispanic whites, and the percentage of uninsured African-Americans was twice as high as for non-Hispanic whites (Figure 3.2).

Figure 3.2. Estimated percent of the adult (age 18 or older) South Texas population with no

health insurance by race/ethnicity, 2002-2005.

It was estimated that, in 2002-2005, a little more than half of all adults ages 18-29 in South Texas had no health insurance (Figure 3.3). This youngest adult age group had the highest rate of uninsured individuals. The percentage of individuals with no health insurance dropped steadily with age (Figure 3.3).

Percent No Health Insurance in South Texas, by Race/Ethnicity, 2002-2005 0 5 10 15 20 25 30 35 40 45 50

Non-Hispanic White Hispanic African-American Other

Race/Ethnicity P e rc e nt

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Figure 3.3. Estimated percent of the adult (age 18 and older) South Texas population with no

health insurance by age group, 2002-2005.

Health professional shortage areas (HPSAs)

Another major barrier to receiving adequate health care is a shortage of health care providers in certain locations. Twenty-one of the 38 South Texas counties are currently designated by the U.S. Department of Health and Human Services as (whole county service area) primary care health professional shortage areas (HPSAs).4

The counties designated as primary care HPSAs in South Texas are shown in Figure 3.4. The HPSAs in this list are mostly non-metropolitan counties. However, a few

metropolitan counties (such as Atascosa, Bandera, Medina, and Wilson) are designated as HPSAs, so a shortage of health professionals is also a problem in some South Texas metropolitan areas.4

Percent of No Health Insurance in South Texas by Age Group, 2002-2005 0 10 20 30 40 50 60 18-29 30-44 45-64 65+ Age Group P e rc e nt

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Figure 3.4. Map of currently designated whole county primary care health professional shortage areas in South Texas.

Webb Val Verde Duval Frio Kerr Starr Edwards Kenedy Bee Uvalde Bexar Hidalgo Kinney Zavala Dimmit Medina La Salle Zapata Real Maverick Nueces Brooks Atascosa Kleberg Gillespie Cameron Wilson Live Oak McMullen Jim Hogg Karnes Willacy Bandera Jim Wells Kendall Comal Guadalupe San Patricio

Source: DSHS, Environmental & Injury Epidemiology & Toxicology Branch, May 2007. Map Produced by DSHS, Center for Health Statistics, June 2007.

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References

1. Zuvekas SH, Weinick RM. Changes in Access to Care, 1977-1996: The Role of Health Insurance. Health Serv Res 1999; 34:271-279.

2. Ramirez AG, McAlister A, Gallion KJ, Villarreal R. Targeting Hispanic

Populations: Future Research and Prevention Strategies. Environ Health Perspect 1995; 103:287-290.

3. Weinick RM, Zuvekas SH, Drilea S. Research Findings #3: Access to Health Care - Sources and Barriers, 1996. Agency for Healthcare Research and Quality. 2006. Accessed 2007 April;

http://www.meps.ahrq.gov/mepsweb/data_files/publications/rf3/rf3.shtml.

4. Primary Care HPSA Designations: Whole County, Texas 2007. Texas Department of State Health Services. 2007. Accessed 2007 May;