Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F-78, Atlanta, GA 30341, United States of America.
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F-78, Atlanta, GA 30341, United States of America.
Prev Med. 2021 Jul;148:106520. doi: 10.1016/j.ypmed.2021.106520. Epub 2021 Mar 17.
Health insurance coverage has increased overtime in the US. This study examined the associations between health insurance status and adoption of health-related behaviors among US adults. Using data collected through the 2017 Behavioral Risk Factor Surveillance System on health insurance coverage and type of insurance, we examined four health-related behaviors (i.e., no tobacco use, nondrinking or moderate drinking, meeting aerobic physical activity recommendations, and having a healthy body weight) and their associations with health insurance status. We conducted log-linear regression analyses to assess the associations with adjustment for potential confounders. Results showed the percentages of adults who reported no tobacco use or meeting physical activity recommendations were significantly higher, and the percentages of adults with a healthy body weight were significantly lower among those who were insured versus uninsured, or among adults with private insurance versus uninsured. Adults with health insurance also had a higher prevalence of reporting all 4 health-related behaviors than those uninsured. These patterns persisted after multivariable adjustment for potential confounders including sociodemographics, routine checkup, and number of chronic diseases. Adults with public insurance were 7% more likely to report no tobacco use than adults who were uninsured. Additionally, adults with private insurance were 8% and 7% more likely to report no tobacco use and meeting physical activity recommendations, respectively, but 10% less likely to report nondrinking or moderate drinking than adults with public insurance. In conclusion, we found significant associations existed between having health insurance coverage and engaging in some health-related behaviors among US adults.
美国的医疗保险覆盖范围一直在扩大。本研究考察了美国成年人的医疗保险状况与健康相关行为的采用之间的关系。我们使用 2017 年行为风险因素监测系统收集的有关医疗保险覆盖范围和保险类型的数据，研究了四种健康相关行为（即不吸烟、不饮酒或适度饮酒、达到有氧运动活动建议和保持健康体重）及其与医疗保险状况的关系。我们进行了对数线性回归分析，以评估在调整潜在混杂因素后的关联。结果表明，与未参保者相比，参保者报告不吸烟或达到体力活动建议的比例显著更高，而报告健康体重的比例显著更低；与未参保者相比，拥有私人保险的成年人报告所有 4 种健康相关行为的比例也更高。这些模式在对包括社会人口统计学、常规检查和慢性病数量等潜在混杂因素进行多变量调整后仍然存在。与未参保者相比，拥有公共保险的成年人报告不吸烟的可能性高 7%。此外，与拥有公共保险的成年人相比，拥有私人保险的成年人报告不吸烟和达到体力活动建议的可能性分别高 8%和 7%，但报告适度饮酒或不饮酒的可能性低 10%。总之，我们发现美国成年人的医疗保险覆盖范围与某些健康相关行为之间存在显著关联。
