HealthConnections – Determining the Impact of Removing Social Barriers to Accessing Healthcare Among Low-Income and Disadvantaged Families

Social barriers to accessing health care negatively impact health outcomes for low-income families contributing to the rise of health care costs in America.  According to the University of Wisconsin Public Health Institute (UWPHI; 2013), working in partnership with the Robert Wood Johnson Foundation (RWJF; 2012), four health factors influence health outcomes as measured by morbidity (quality of life) and mortality (length of life). According to UWPHI (2012), the four factors include health behaviors, clinical care, social and economic factors and physical environment. Until recently, managed care organizations participating in government programs like managed Medicaid and Medicare, have historically focused on clinical care (World Health Organization, 2008).  Determinants of health represent a significant concern within the public health care system and represent one of the Healthy People 2020’s (2014) four foundational health measures.

Using raw data from the County Health Rankings site and selected “health outcomes” data for the commonwealth of Kentucky as well as “social & economic factors”, “access to care” and “insufficient social supports”,  the HealthConnections researcher loaded the selection into the Statistical Package for the Social Sciences (SPSS) along with a five-digit Federal information Processing Standard (FIPS) data the United States Census Bureau (Census) to link all data sources by county. With this data housed in SPSS, the  HealthConnections researcher first conducted a Chi-square test of independence and then prepared a multiple regression analysis to determine the R and R2 factor that leads to determining independent variable predicability of the dependent variable.  Study analysis reveals a correlation among several but not all factors.  First, with a X2 of .827 social and economic factors correlate strongly with health outcomes. To a lesser degree and with a X2 of .588, insufficient social supports also correlate with health outcomes. A Sig. factor of .000 represents a signficant correlation. Alternatively, the available social services correlate only with access to care also with a sig. factor of .000. With the correlation established, the HealthConnections researcher then conducted a linear regression analysis to determine potential causal relationships among the variables. The data above adds to the growing quantifiable evidence that social determinants impact health outcomes and there is a correlation of removing social barriers to accessing health care to improve health outcomes while adding analysis of the impact of the social service availability on access to care.


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