ArticlePreventive medicine2016
Disparities in the prevalence of comorbidities among US adults by state Medicaid expansion status.
Article in Preventive medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed.
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- Allostatic Load, Educational Attainment, and Risk of Cancer Mortality Among US Men.JAMA network open · 2024Article
- Prevalence, Management, and Comorbidities of Adults With Atrial Fibrillation in the United States, 2019 to 2023.JACC. Advances · 2024Article
- Medical financial hardship in the Southern United States: the struggle continues across generations pre- and post- the Affordable Care Act.Research in health services & regions · 2024Article
- Validity of the Chinese multimorbidity-weighted index in measuring disease burden using health check-ups data in primary care.BMC public health · 2024Article
- Article
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- Importance of primary care for underserved cancer patients with multiple chronic conditions.Journal of cancer survivorship : research and practice · 2023Article
- The Role of BMI in Allostatic Load and Risk of Cancer Death.American journal of preventive medicine · 2023Article
- Investigating the association between educational attainment and allostatic load with risk of cancer mortality among African American women.BMC women's health · 2023Article
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Authors and funding
4 authors.
Funding
Abstract
introductionAbout 92% of US older adults have at least one chronic disease or medical condition and 77% have at least two. Low-income and uninsured adults in particular experience a higher burden of comorbidities, and the Medicaid expansion provision of the Affordable Care Act was designed to improve access to healthcare in this population group. However, a significant number of US states have declined expansion. The purpose of this study is to determine the distribution of low-income and uninsured adults in expanded versus non-expanded states, and evaluate the prevalence of comorbidities in both groups.
methodsData from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) dataset was analyzed, and Medicaid expansion status was assessed from the Center for Medicare and Medicaid Services report on State Medicaid and CHIP Income Eligibility Standards. Next, age adjusted mean number of comorbidities between expanded and non-expanded states was compared, with adjustment for socio-demographic differences.
resultsExpanded states had a higher proportion of adults with income of at least $50,000 per year (39.6% vs. 35.5%, p<0.01) and a lower proportion of individuals with no health insurance coverage (15.2% vs. 20.3%, p<0.01) compared with non-expanded states. Among the uninsured, there was a higher proportion of obese (31.6% vs. 26.9%, p<001), and higher average number of comorbidities (1.62 vs. 1.52, p<0.01) in non-expanded states compared to expanded states. Overall, the prevalence of comorbidities was higher among BRFSS participants in states that did not expand Medicaid compared with those in expanded states.
conclusionStates without Medicaid expansion have a greater proportion of poor, uninsured adults with more chronic diseases and conditions.
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