Across all incomes, insurance coverage increased the likelihood that adults received blood pressure and cholesterol screening. For adults in households with income below 250% of the federal poverty level, insurance coverage increased the likelihood of pap smears, mammograms or colon cancer screening.
However, low-income adults were more likely to be uninsured, and uninsured for longer periods, than those with higher household income, the survey found.
“The urgency for looking at this group is motivated by the widening income divide in the U.S. economy as a whole,” Sara Collins, vice president of affordable health insurance for the Commonwealth Fund and one of the report's authors, said during a conference call Monday.
The survey is the first in a series by the Commonwealth Fund that will track household insurance status and access to medical care annually. The health policy not-for-profit also has plans for separate surveys of young adults and older adults, Collins said.
In households with incomes below 133% of the federal poverty level, 44% of adults reported seeking care for themselves or family at an emergency room in the evenings or on weekends. That's compared with 23% of adults in households with incomes at or above 400% of the federal poverty level, the survey found.
Low-income respondents were also more likely than higher-income adults to cite cost concerns or lack of a regular doctor—not a medical emergency—as reasons for a trip to the emergency room. Nearly half (47%) of adults with income below 133% of the federal poverty guideline said need for a prescription drug was among the reasons for an ER visit. That's compared with 20% of those in households with income at or above 400% of federal poverty.
Regardless of income, uninsured adults were significantly less likely (roughly half) to have a regular source of medical care—a doctor, medical group, health center or clinic—than the insured (92%).
“People in the bottom half of the income distribution, on average, have dramatically different healthcare experiences than those at the top,” the authors wrote. “The consequences of this widening gulf are strikingly evident in the health insurance system—having health insurance coverage is nearly entirely dependent on whether it is offered though a job. People with low and moderate incomes run the highest risk of lacking job-based health insurance, are least able to afford the cost of coverage if they have to buy it on their own, and are the most at risk of not being able to afford care in the absence of health insurance coverage.”
The online survey, conducted by Knowledge Networks, included nationally representative sample of 2,134 of adults ages 64 and younger. The survey was conducted June 24, 2011 through July 5, 2011.