234825 No Money, No Home, No Care: The impact of income, public assistance, and a history of homelessness on medical care seeking behavior

Monday, October 31, 2011: 8:50 AM

Misha Granado, MPH, MS , Emergency Medicine, University of Texas-Health Science Center, Houston, TX
Mandy J. Hill, DrPH, MPH , Emergency Medicine, University of Texas Health, Medical School, Houston, TX
Michael W. Ross, PhD , WHO Center for Health Promotion Research and Development, The University of Texas - Houston School of Public Health, Houston, TX
     
Objective: To assess gender differences and determine whether economic determinants are correlated to delayed medical care among an at-risk, majority African American population in Houston, TX.

Methods: Questionnaires administered to 215 Houston residents. Participants were recruited from clinics and club/bars locally. A chi-square analysis revealed economic determinants - source of income, public assistance, and a history of homelessness - were associated with delayed medical care. Logistic regression models calculated odds ratios and 95% confidence intervals. Findings were stratified by 1) individual or collective entry into the regression model, 2) gender, and 3) a total analysis of cases and places, cases only, and/or places only.

Results: The individual regression analysis revealed participants with a history of homelessness were 2 times more likely to delay medical care (OR=2.21, 1.04-4.71). Men with an income source were less likely to delay medical care (OR=.09, .02-.53). In addition, men who received public assistance were 16 times more likely to delay medical care (OR=16.33, 1.67-159.75). Women among places with a history of homelessness were more likely to delay medical care (OR=3.03, 1.03-8.89). When analyzed collectively, the relationship between public assistance and delayed medical care persisted among men (OR=19.25, 1.37-270.32). The relationship between an income source and delayed medical care (OR=.03, .00-.48) among men alongside the correlation between a history of homelessness and delayed medical care (OR=3.55, 1.29-9.76) among places remained significant.

Conclusion: This assessment revealed a gender difference in the relationship between economic determinants and willingness to sustain physical health. Future research should explore this correlation among similar populations for the purpose of generalizing the findings and designing interventions purposed to improve medical care access in spite of economic pitfalls.

Learning Areas:
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
To assess gender differences and determine whether economic determinants are correlated to delayed medical care among an at-risk, majority African American population in Houston, TX.

Keywords: Homeless Health Care, Poverty

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a co-author on the manuscript submitted with the data described in this abstract, I am qualified to present, as I am very familiar with the subject matter and data set.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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