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AJPH NEWS Release

EMBARGOED UNTIL December 30, 2002 4:00 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511

All articles are online at http://www.ajph.org/

American Journal of Public Health: January 2003 Highlights

• -Even occasional lack of health insurance results in less preventive care
• -Primary care providers can break down barriers to care for vulnerable patients

The articles highlighted below appear in the January 2003 issue of the American Journal of Public Health, the Journal of the American Public Health Association.

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Even occasional lack of health insurance results in less preventive care
Lack of health insurance is a particular problem among people who may only go short periods without coverage because that population is less likely to seek recommended follow-up care, care for chronic conditions and crucial preventive care. In a study sample of 7,300 people ages 51-61 who responded to a national health survey in 1992, 1994 and 1996, researchers found that intermittent lack of insurance coverage, even across a four-year period, resulted in less access to care . Particularly lacking: cholesterol tests, Pap testsand mammograms among women, and prostate cancer screening for men. Other studies have shown that early breast cancer screening can reduce death rates by up to 60 percent. "Our results extend the findings of other studies showing that periods of noncoverage increase people's risk of going without needed care and increase the likelihood that they will report problems involving access to care," the study's authors wrote. "Additional policy initiatives are needed to promote stability in insurance coverage."
[From: : "Intermittent Lack of Health Insurance Coverage and Use of Preventive Services." Contact: Joseph J. Sudano Jr., PhD, MetroHealth System, Cleveland; contact jsudano{at}metrohealth.org.]

Primary care providers can break down barriers to care for vulnerable patients
Having an easily accessible and trustworthy primary care provider is one of the best ways to ensure access to critical health services, according to a recent study. Researchers looked at more than 18,000 people surveyed for the 1996-1997 nationwide Community Tracking Study and found that those who believed they could trust their primary care provider and rated that provider as competent and a good communicator were most likely to receive both primary care and referrals to specialty care. And while minorities and low-income populations traditionally have less access to care than the general population, those "vulnerable" patients with a good patient-provider relationship were much more likely to receive essential health care. Primary care providers included doctors, physician assistants and nurse practitioners.
[From: "Vulnerability and the Patient-Practitioner Relationship: The Roles of Gatekeeping and Primary Care Performance." contact Leiyu Shi, DrPH, Department of Health Policy and Management, Baltimore, lshi{at}jhsph.edu.]

The American Journal of Public Health is the monthly Journal of the American Public Health Association, the oldest and largest organization of public health professionals in the world and the foremost publisher of public health-related books and periodicals promoting high scientific standards, action programs and policy for good health. The Journal is online at www.ajph.org.

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