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Complete Health Indicator Report of Cost as a Barrier to Health Care

Definition

Percentage of adults aged 18 years and older who reported they were unable to receive needed health care in the past year due to cost.

Numerator

Number of survey respondents who reported they were unable to receive needed health care in the past year due to cost.

Denominator

Total number of survey respondents excluding those with missing, "Don't know/Not sure", and "Refused" answers.

Data Interpretation Issues

Question Text: "Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?" Starting in 2009, the BRFSS included both landline and cell phone respondent interviews along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf]. As with all surveys, some error results from nonresponse (e.g., refusal to participate in the survey or to answer specific questions), and measurement (e.g., social desirability or recall bias). Error was minimized by use of strict calling protocols, good questionnaire design, standardization of interviewer behavior, interviewer training, and frequent, on-site interviewer monitoring and supervision.

Why Is This Important?

Access to health care is still a problem for many Utahns. Individuals who cannot obtain needed health care tend to have higher rates of death and disability from chronic disease. Cost is the most commonly reported barrier to getting needed health care.

Other Objectives

Related to HP2020 Objective AHS-6.2: Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care[[br]]'''U.S. Target:''' 4.2%

How Are We Doing?

The age-adjusted percentage of Utah adults who reported being unable to see a doctor in the past 12 months due to cost increased to 13.4% in 2017. This level is the highest it has been since 2014, when the rate was 14.1%. The percentage (crude rate) was the highest for adults aged 25-34 (18.0%) and lowest for Utah adults aged 65 and older (4.6%). In 2017, Utah adults with low incomes had a higher age-adjusted rate (26.9%) of reporting cost as a barrier to health care than those with higher incomes (6.5%), as did those without health insurance (32.3%) versus the insured (10.6%).

How Do We Compare With the U.S.?

When comparing Utah to the U.S. as a whole, the age-adjusted percentage of adults who reported they were unable to get needed health care in the past year due to cost has been similar over the years. In 2017, this percentage was 14.0% in the U.S. compared to 13.4% in Utah.

What Is Being Done?

The Utah Department of Health administers programs to improve access to care, such as Medicaid, the Children's Health Insurance Program (CHIP), the Primary Care Network (PCN), UPP (Utah's Premium Partnership for Health Insurance), primary care grants, and clinics for children with disabilities. Local health departments provide preventive services such as immunizations and screenings at low or no cost to eligible persons who cannot afford them. Members of the Association for Utah Community Health (AUCH), including Federally Qualified Health Centers and other providers, strive to meet the needs of the medically underserved in Utah.

Available Services

Utah Medicaid Program: [[br]] phone 1-800-662-9651, or visit [http://www.health.utah.gov/medicaid/] Utah Department of Health's Primary Care Network (PCN): [[br]] phone 1-888-222-2542 or visit [http://www.health.utah.gov/pcn/] Utah Children's Health Insurance Program (CHIP): [[br]] phone 1-877-KIDS-NOW (1-877-543-7669) or visit [http://www.health.utah.gov/chip] UPP (Utah's Premium Partnership for Health Insurance): [[br]] phone: 1-888-222-2542 (M - F, 8 a.m. -5 p.m.) [[br]] or visit [http://www.health.utah.gov/upp] The Association for Utah Community Health (AUCH) is the primary care association for the state of Utah. AUCH members include Federally Qualified Health Centers (FQHC) and other providers who strive to meet the needs of the medically underserved. AUCH and its member organizations are part of a statewide and national movement to reduce barriers to health care by enhancing primary care service delivery through prevention, health promotion, and community participation. Association for Utah Community Health [[br]] 860 East 4500 South [[br]] Salt Lake City, UT 84107 [[br]] Phone: (801) 974-5522 [[br]] [http://www.auch.org]


Related Indicators

Relevant Population Characteristics

Persons with low incomes have a higher percentage of problems with access to care than persons with higher incomes.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Persons without health insurance have a higher percentage reporting cost as a barrier to care than those with health insurance coverage.

Related Health Care System Factors Indicators:


Health Status Outcomes

Persons without access to health care tend to delay getting care until a problem becomes too painful or dangerous to avoid dealing with it. At this point, health problems are often expensive to treat and sometimes have serious long term implications for the individual's health. The health status of these persons may suffer due to lack of appropriate care.

Related Health Status Outcomes Indicators:




Graphical Data Views

Adults Reporting Cost as a Barrier to Care in Past Year by Age Group, Utah, 2017

::chart - missing::
confidence limits

Age GroupPercentage of AdultsLower LimitUpper Limit
Record Count: 6
18-2413.8%11.5%16.5%
25-3418.0%15.8%20.5%
35-4416.4%14.3%18.8%
45-5414.3%12.2%16.6%
55-6411.8%10.0%13.9%
65+4.6%3.7%5.8%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adults Reporting Cost as a Barrier to Care in Past Year by Income Category, Utah, 2017

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confidence limits

Income CategoryAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 6
<$25,00026.9%23.8%30.2%
$25,000-$49,99916.7%14.6%19.0%
$50,000-$74,99911.4%9.5%13.5%
$75,000+6.5%5.4%7.8%
Total13.4%12.5%14.3%

Data Notes

Age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adults Age 25 and Older Reporting Cost as a Barrier to Care in Past Year by Education Level, Utah, 2017

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confidence limits

Education LevelAge-adjusted Percentage of Adults Aged 25+Lower LimitUpper Limit
Record Count: 5
Less Than High School22.8%18.3%27.9%
H.S. Grad or G.E.D.16.5%14.5%18.7%
Some Post High School13.4%11.9%15.0%
College Graduate8.2%7.2%9.4%
Total13.3%12.4%14.3%

Data Notes

Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adults Reporting Cost as a Barrier to Care in Past Year by Ethnicity, Utah, 2017

::chart - missing::
confidence limits

Hispanic EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 2
Hispanic20.0%17.0%23.4%
Non-Hispanic12.5%11.6%13.4%

Data Notes

Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adults Reporting Cost as a Barrier to Care in Past Year by Race, Utah, 2015-2017

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confidence limits

RaceAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 6
American Indian/Native Alaskan21.0%16.1%26.8%
Asian12.6%8.8%17.7%
Black20.5%14.6%28.0%
Pacific Islander23.2%16.1%32.2%
White11.5%11.0%12.0%
All Races12.5%12.1%13.0%

Data Notes

Age-adjusted to U.S. 2000 standard population based on 3 age groups: 18-34, 35-49, and 50+.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adults Reporting Cost as a Barrier to Care in Past Year by Insurance Status, Utah, 2015-2017

::chart - missing::
confidence limits

Insurance StatusYearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 6
Have Insurance20159.1%8.4%9.8%
Have Insurance20168.8%8.1%9.7%
Have Insurance201710.6%9.8%11.5%
Do Not Have Insurance201535.4%31.7%39.3%
Do Not Have Insurance201630.0%26.3%33.9%
Do Not Have Insurance201732.3%28.5%36.3%

Data Notes

Age-adjusted to the U.S. 2000 standard population. This graph utilizes a single question to measure insurance and may reflect different rates of coverage than other reports that include multiple insurance questions.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Cost as a Barrier to Care in Past Year by Local Health District, Utah and U.S., 2017

::chart - missing::
confidence limits

Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 15
Bear River13.8%10.6%17.6%
Central18.7%14.6%23.8%
Davis County10.8%8.6%13.5%
Salt Lake County14.5%12.9%16.1%
San Juan17.5%10.5%27.8%
Southeast14.2%9.9%20.0%
Southwest13.5%10.5%17.3%
Summit12.1%7.9%18.1%
Tooele14.8%10.2%21.0%
TriCounty11.4%8.8%14.6%
Utah County10.3%8.7%12.1%
Wasatch8.4%5.1%13.6%
Weber-Morgan14.3%11.7%17.5%
State of Utah13.4%12.5%14.3%
U.S.14.0%13.8%14.3%

Data Notes

Age-adjusted to the U.S. 2000 standard population. Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point.

Data Sources

  • Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services


Adults Reporting Cost as a Barrier to Care in Past Year by Utah Small Area, 2015-2017

::chart - missing::
confidence limits

Utah Small AreasAge-adjusted Percentage of AdultsLower LimitUpper LimitNote
Record Count: 130
Brigham City9.3%5.7%14.7%
Box Elder (Other) V26.9%3.4%13.7%*
Tremonton12.7%7.4%21.1%
Logan V215.5%11.9%19.9%
North Logan11.3%7.2%17.2%
Cache (Other)/Rich V29.7%6.4%14.4%
Hyrum5.4%2.4%11.6%*
Smithfield15.0%8.4%25.5%
Ben Lomond12.1%9.3%15.6%
Weber County (East)9.4%6.4%13.7%
Morgan County11.7%6.7%19.9%
Ogden (Downtown)13.9%10.4%18.4%
South Ogden10.8%7.4%15.4%
Roy/Hooper12.6%9.3%16.9%
Riverdale16.2%11.4%22.5%
Clearfield Area/Hooper9.3%6.9%12.5%
Layton/South Weber12.7%9.9%16.1%
Kaysville/Fruit Heights5.5%3.4%8.7%
Syracuse4.3%2.1%8.7%*
Centerville5.1%2.2%11.3%*
Farmington6.6%3.1%13.6%*
North Salt Lake11.1%6.3%18.8%
Woods Cross/West Bountiful9.7%4.8%18.6%*
Bountiful10.4%7.5%14.4%
SLC (Rose Park)17.0%12.0%23.6%
SLC (Avenues)13.2%8.1%20.7%
SLC (Foothill/East Bench)5.3%2.6%10.5%*
Magna10.1%6.5%15.4%
SLC (Glendale)23.3%16.4%32.0%
West Valley (Center)19.5%15.1%24.7%
West Valley (West) V212.9%7.9%20.4%
West Valley (East) V218.0%13.5%23.6%
SLC (Downtown) V214.8%10.4%20.6%
SLC (Southeast Liberty)15.3%10.2%22.2%
South Salt Lake18.1%12.4%25.7%
SLC (Sugar House)11.6%7.4%17.5%
Millcreek (South)11.7%6.9%19.1%
Millcreek (East)9.7%5.5%16.6%
Holladay V213.3%8.1%21.2%
Cottonwood14.7%10.5%20.3%
Kearns V213.0%9.0%18.5%
Taylorsville (E)/Murray (W)17.4%12.9%23.2%
Taylorsville (West)17.8%13.3%23.3%
Murray16.0%10.8%23.1%
Midvale13.8%9.0%20.6%
West Jordan (Northeast) V28.4%4.8%14.4%
West Jordan (Southeast)13.6%9.5%19.2%
West Jordan (West)/Copperton12.7%9.1%17.6%
South Jordan V28.2%5.4%12.3%
Daybreak13.8%8.4%22.1%
Sandy (West)15.7%10.3%23.4%
Sandy (Center) V29.8%6.3%14.9%
Sandy (Northeast)11.4%6.7%18.7%
Sandy (Southeast)3.6%1.8%7.1%*
Draper8.5%5.4%13.3%
Riverton/Bluffdale6.8%4.3%10.6%
Herriman9.4%6.3%13.7%
Tooele County (Other)16.2%10.3%24.5%
Tooele Valley14.1%11.2%17.6%
Eagle Mountain/Cedar Valley10.6%6.0%18.3%
Lehi9.8%6.7%14.0%
Saratoga Springs11.0%6.6%17.6%
American Fork8.6%5.4%13.4%
Alpine****
Pleasant Grove/Lindon9.4%6.6%13.2%
Orem (North)15.6%11.4%21.1%
Orem (West)13.7%9.9%18.7%
Orem (East)13.0%8.4%19.7%
Provo/BYU9.9%6.3%15.1%
Provo (West City Center)18.9%13.1%26.3%
Provo (East City Center)7.3%3.6%14.2%
Salem City10.9%5.5%20.3%*
Spanish Fork11.5%7.9%16.4%
Springville15.3%10.9%21.0%
Mapleton8.1%4.1%15.4%*
Utah County (South) V29.5%5.1%17.2%*
Payson12.4%8.2%18.4%
Park City14.4%10.3%19.8%
Summit County (East)13.8%9.2%20.2%
Wasatch County9.5%6.7%13.2%
Daggett and Uintah County14.8%12.2%18.0%
Duchesne County12.9%9.8%16.8%
Nephi/Mona19.8%12.6%29.6%
Delta/Fillmore12.9%7.8%20.8%
Sanpete Valley11.5%8.4%15.7%
Central (Other)15.1%11.2%20.0%
Richfield/Monroe/Salina11.6%7.3%17.9%
Carbon County11.3%8.1%15.5%
Emery County11.6%6.5%19.7%
Grand County25.8%17.2%36.7%
Blanding/Monticello15.6%10.1%23.4%
San Juan County (Other)17.1%9.7%28.4%
St. George10.3%7.9%13.4%
Washington County (Other) V220.0%12.6%30.1%
Washington City14.7%8.9%23.3%
Hurricane/La Verkin14.2%9.2%21.2%
Ivins/Santa Clara13.3%6.5%25.4%*
Cedar City17.2%13.1%22.1%
Southwest LHD (Other)10.5%7.2%15.3%
State of Utah12.4%11.9%12.9%

Data Notes

Age-adjusted to the U.S. 2000 standard population. * Use caution in interpreting rates. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards. ** The estimate has been suppressed because the relative standard error is greater than 50% or the observed number of events is very small and not appropriate for publication. For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf]. A description of the Utah Small Areas may be found on IBIS at the following URL: [https://ibis.health.utah.gov/resource/Guidelines.html].

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adults Reporting Cost as a Barrier to Care in Past Year, Utah and U.S., 1991-2000 and 2003-2017

::chart - missing::
confidence limits

BRFSS Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 56
UT Old Methodology199112.0%10.5%13.8%
UT Old Methodology199212.9%11.4%14.6%
UT Old Methodology199312.1%10.6%13.8%
UT Old Methodology199413.5%11.9%15.4%
UT Old Methodology199510.8%9.4%12.3%
UT Old Methodology199610.6%9.3%12.1%
UT Old Methodology19979.6%8.4%11.0%
UT Old Methodology19988.8%7.5%10.3%
UT Old Methodology19999.8%8.5%11.2%
UT Old Methodology200010.2%8.9%11.7%
UT Old Methodology2001**
UT Old Methodology2002**
UT Old Methodology200312.6%11.2%14.0%
UT Old Methodology200412.1%11.0%13.3%
UT Old Methodology200512.7%11.6%13.8%
UT Old Methodology200611.7%10.6%12.8%
UT Old Methodology200711.4%10.3%12.7%
UT Old Methodology200811.6%10.5%12.9%
UT Old Methodology200912.7%11.8%13.7%
UT Old Methodology201013.4%12.5%14.5%
US Old Methodology199111.6%11.3%11.9%
US Old Methodology199213.0%12.7%13.4%
US Old Methodology199313.0%12.7%13.3%
US Old Methodology199412.4%12.0%12.7%
US Old Methodology199511.4%11.1%11.8%
US Old Methodology199611.2%10.9%11.5%
US Old Methodology199710.7%10.4%11.0%
US Old Methodology199810.1%9.8%10.3%
US Old Methodology199910.3%10.1%10.6%
US Old Methodology200010.6%10.4%10.9%
US Old Methodology2001**
US Old Methodology2002**
US Old Methodology200313.0%12.7%13.2%
US Old Methodology200413.5%13.3%13.8%
US Old Methodology200513.7%13.4%13.9%
US Old Methodology200613.4%13.1%13.7%
US Old Methodology200713.7%13.4%13.9%
US Old Methodology200814.2%14.0%14.5%
US Old Methodology200915.1%14.8%15.4%
US Old Methodology201015.0%14.7%15.2%
UT New Methodology200915.6%14.6%16.6%
UT New Methodology201016.3%15.4%17.2%
UT New Methodology201116.3%15.4%17.2%
UT New Methodology201215.0%14.1%15.9%
UT New Methodology201314.8%14.0%15.6%
UT New Methodology201414.1%13.4%14.8%
UT New Methodology201512.3%11.5%13.1%
UT New Methodology201611.6%10.8%12.5%
UT New Methodology201713.4%12.5%14.3%
US New Methodology201117.3%17.0%17.5%
US New Methodology201217.1%16.8%17.3%
US New Methodology201316.5%16.2%16.7%
US New Methodology201414.9%14.6%15.1%
US New Methodology201513.8%13.6%14.0%
US New Methodology201613.5%13.3%13.7%
US New Methodology201714.0%13.8%14.3%

Data Notes

Age adjusted to U.S. 2000 standard population. U.S. data are the average for all states and the District of Columbia but do not include the U.S. territories. Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point. **This question was not asked in 2001 or 2002. The data in this graph include estimates from the old landline-only methodology, and from the new methodology that includes both landline and cell phone respondent interviews along with a new weighting methodology called iterative proportional fitting, or raking. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Data Sources

  • Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services

References and Community Resources

More information on the Behavioral Risk Factor Surveillance System may be found on the website of the Centers for Disease Control and Prevention - [http://www.cdc.gov/brfss/]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 10/15/2018, Published on 10/23/2018
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 17 December 2018 7:51:26 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 23 Oct 2018 15:43:37 MDT