Wealth Related Disparities in Preventive Care, Access, and Coverage Among the Chronically Ill

Abstract:     
Disparities in health status and health outcomes are of growing policy focus. In the U.S., there are many efforts to improve the quality of care and reduce disparities by race, ethnicity, gender and geography. It is well known that income and socio-economic status (SES) are strongly related to health status. A large body of research has documented the relationship between income and health but there are fewer studies of the relationship between wealth and health. This is likely due to the difficulty in collecting information on assets and debts in health surveys. Newly available data on asset holdings in the Medical Expenditure Panel Survey allow for a more detailed examination of the relationship between wealth and health and the various factors that can mediate disparities in health status such as insurance coverage, access to care and use of services.

In earlier research we find that there is a strong relationship between wealth and insurance coverage, controlling for income. In this paper, we look beyond the demand for insurance and examine the relationship between wealth and the demand for health care services. More specifically, we are interested in the association between wealth and use of preventive care, especially among persons with chronic conditions, while controlling for other factors such as income and insurance status. Victor Fuchs hypothesized that wealth and health were both affected by a third variable such as time preference. Forward-looking individuals are more likely to undertake measures that may cost them in the current period but will improve their utility in the future, such as demand preventive health care services. We hypothesize that wealth is associated with greater demand for preventive care. We test if the relationship between wealth and use of preventive care services differs by age group. The results of this research should help policymakers design targeted interventions that reduce health disparities among persons with chronic conditions.

Keywords: health, wealth, preventive care, chronic conditions

JEL Classification: I10, I12, D10

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