National Healthcare Disparities Report - LDI Health Economist

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Priority Populations Postponement Respondents were asked whether they postponed or did not try to get two types of health care: preventive care “like checkups” and necessary care “when sick or injured.” Many postponed care because they could not afford it, and many postponed care because of discrimination and disrespect from providers. Figure 10.3. Postponement of care due to discrimination Chapter 10 50 45 40 35 30 Postponement Due to Discrimination by Providers 48% 42% 33% 29% 25 20 15 10 22% 17% 18% 23% 5 0 MTF FTM GNC (MTF GNC (FTM Spectrum Spectrum Source: Reprinted from the National Transgender Discrimination Survey Report on Health and Health Care, 2011. Needed Care Preventive Care A significant number of study participants postponed needed medical care due to inability to afford it, whether seeking care when sick or injured (48%) or pursuing preventive care (50%). FTM transgender respondents report postponing care due to inability to afford it at higher rates (55%) than MTF transgender respondents (45%). Insurance played a significant factor: those who have private insurance were much less likely to postpone care because of inability to afford it when sick or injured (37%) than those with public (46%) or no insurance (86%). In terms of preventive care, those without insurance reported delaying care due to inability to afford it much more frequently (88%) than those with private insurance (39%) or public insurance (44%). Failing to obtain preventive care is known to lead to poor long-term health outcomes. Due to discrimination and disrespect, 28% postponed or avoided medical treatment when they were sick or injured, and 33% delayed or did not try to get preventive health care. FTM transgender respondents reported postponing care due to discrimination and disrespect at a much higher frequency (42%, sick/injured; 48%, preventive) than MTF transgender respondents (22%, sick/injured; 25%, preventive). 244 National Healthcare Disparities Report, 2011
Priority Populations Those with the highest rates of postponement included those who have lost a job due to bias (45%) and those who have done sex work, sold drugs, or engaged in other underground economies for income (45%). Twentynine percent of respondents who were “out” or “mostly out” to medical providers reported they had delayed care when ill, and 33% postponed or avoided preventive care because of discrimination by providers. Access to Insurance Figure 10.4. Source of insurance No Insurance Current or Former Employer Source of Insurance Chapter 10 Someone Else’s Employer Medicare Purchased Military Health Care Other Public Health Care Student Insurance Medicaid Other 0 5 10 15 20 25 30 35 40 45 50 Source: Reprinted from the National Transgender Discrimination Survey Report on Health and Health Care, 2011. Study participants were less likely than the general population to have health insurance, more likely to be covered by State programs such as Medicaid, and less likely to be insured by an employer. Nineteen percent of the sample lacked any health insurance compared with 15% of the general population (DeNavas-Walt, et al., 2009). African-American respondents had the worst health insurance coverage of any racial category: 39% reported private coverage and 30% public. Thirty-one percent of Black respondents reported being uninsured; by contrast, 66% of White respondents reported private insurance, 17% public insurance, and 17% no insurance. Undocumented noncitizens had very low rates of coverage: 26% reported private insurance, 38% public insurance, and 36% no insurance. The South was the lowest region for coverage, where 59% of respondents reported private insurance, 17% public insurance, and 25% no insurance. In terms of gender, MTFs reported private insurance at 56%, public insurance at 23%, and no insurance at 20%. Gender-nonconforming respondents were insured at higher rates than their transgender counterparts, with 73% private insurance, 11% public insurance, and 17% uninsured. National Healthcare Disparities Report, 2011 245
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NATIONAL HEALTHCARE DISPARITIES REP
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Acknowledgments The NHQR and NHDR a
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Introduction and Methods With rapid
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Care Coordination Importance Chapte
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