Health and health care access of unemployed during a recession: An investigation in a state with health reform

Background. Despite the economic downturn and an unemployment rate likely reaching double digits, congressional efforts for national health care reform continue. This reform may be similar to landmark Massachusetts Legislation passed in better economic times. An investigation of the health and health care access of the growing population of unemployed will inform the national health reform debate.

Purpose. To investigate self-rated physical and mental health, health care access and health care needs among unemployed in Massachusetts.

Methods. Cross-sectional design to survey unemployed individuals residing in Massachusetts. A convenience sample was recruited from job fairs and career centers in spring 2009. Instrument questions were obtained from Current Population Survey, Behavioral Risk Factor Surveillance System, and the National Health Interview Survey. Descriptive and multivariate analyses were completed.

Results*. 105 participants were interviewed. 21.1% did not have any health coverage. 27.9% did not have their annual check-ups. 21.2% reported they needed to see a doctor but could not afford. 19.2% could not afford medicine, 41.3% dental care, and 17.3% eye care. 32.6% and 16% reported more than a week of poor mental and physical health in the past 30 days, respectively.

Discussion. Even in a state with near universal health coverage one in every five unemployed individuals is uninsured, with many reporting poor health and decreased health access.

Conclusion. This study contributes to the void in social epidemiology about the impact of unemployment on health. To achieve universal coverage, strategies to cover the unemployed may need expansion in these difficult economic times.