Nationally, young adults 18-29 years of age are more likely to be uninsured than any other age group. In 2008, approximately 14 million young adults in the US were without health insurance coverage. The enactment of the Affordable Care Act is expected to assist the majority of uninsured young adults with acquiring health insurance coverage and potentially increasing their access to healthcare services.

The following article presents findings from PHMC’s 2010 Southeastern Pennsylvania Household Health Survey, with a particular focus on the health and well-being of young adults 18-29 years of age residing in the five-county Southeastern Pennsylvania (SEPA) region of Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties. This article presents information about health insurance and prescription drug coverage as well as access to care, health behaviors and screenings, and neighborhood and housing indicators.

Health and Prescription Drug Coverage

In SEPA, young adults are more likely to not have insurance coverage than any other age group, particularly health and prescription drug coverage.

More than one-fifth of young adults 18-29 years (20.8%) do not have health insurance coverage, representing 103,600 young adults in the SEPA region. Young adults are the age group most likely to not have health insurance coverage: children 0-5 years (3.2%), children 6-12 years (3.1%), adolescents 13-17 years (4.0%), adults 30-49 years (11.0%), and adults 50-64 years (6.8%) (Figure 1).

• Among young adults 18-29 years, young adult men (23.4%) are more likely than young adult women (18.4%) to not have health insurance.
• More than two-fifths of Latino young adults (44.2%) are without health insurance, compared with Asian young adults (22.6%), black young adults (21.5%), and white young adults (15.7%).
• More than one-quarter young adults living below 150% of the Federal Poverty Level (26.6%) do not have health insurance, compared with 19.1% of young adults living at or above 150% of the poverty level.

Young adults are more likely to not have prescription drug coverage (16.4%), compared with adults 30-49 years (8.3%), adults 50-64 years (7.5%), and adults 65 year or older (10.9%).

Health Status and Conditions

In SEPA, while young adults are the least likely age group to be in fair or poor health, they are more likely to have some chronic health conditions. Additionally, young adults are the least likely age group to be either overweight or obese.

Young adults are less likely to be in fair or poor health (9.1%), compared with adults 30-49 years (12.0%), adults 50-64 years (20.2%), and adults 65 years or older (22.9%).

More than one-fifth of young adults (21.4%) have ever been told by a healthcare professional they have asthma, compared with adults 30-49 years (14.5%), adults 50-64 years (15.4%), and adults 65 years or older (9.5%).

Young adults are less likely to be overweight (29.5%), compared with adults 30-49 years (34.2%), adults 50-64 years (37.4%), and adults 65 years or older (40.9%).  Young adults are also less likely to be obese (19.0%), compared with adults 30-49 years (27.4%), adults 50-64 years (31.0%), and adults 65 years or older (23.0%).

Young adults (17.7%) are similarly as likely as adults 30-49 years (15.5%) and adults 50-64 years (15.9%) to have a diagnosed mental health condition; however, young adults are twice as likely as adults 65 years or older (8.4%) to have a diagnosed mental health condition.

Access to Care

In SEPA, young adults are the age group most likely to not have a regular source of care; young adults are also more likely to have experienced cost barriers to receiving care within the past year.

One-fifth of young adults 18-29 years (20.0%) does not have a regular source of care. Young adults are the age group most likely to not have a regular source of care: children 0-5 years (2.8%), children 6-12 years (1.6%), adolescents 13-17 years (3.5%), adults 30-49 years (11.2%), adults 50-64 years (7.4%), and adults 65 years or older (5.2%) (Figure 2).

• Among young adults, young adult men (22.5%) are more likely than young adult women (17.8%) to not have a regular source of care.
• One-third of Latino young adults (33.4%) does not have a regular source of care, compared with 21.0% of black young adults, 19.4% of Asian young adults, and 17.4% of white young adults.

More than three-tenths of young adults (30.3%) have had to forego dental care during the past year due to cost factors, compared with adults 30-49 years (26.6%), adults 50-64 years (24.2%), and adults 65 years or older (14.1%).

• Two-fifths of young adults living below 150% of the Federal Poverty Level (42.5%), compared with 26.8% of young adults living at or above 150% of the poverty level, have had to forego dental care in the past year due to cost factors.

Nearly one-fifth of young adults (18.2%) has had to forego medical care due to cost factors, compared with adults 30-49 years (15.1%), adults 50-64 years (11.1%), and adults 65 years or older (3.9%).

Health Behaviors and Health Screenings

In SEPA, young adults are similarly as likely as other adults to engage in selected healthy behaviors. Additionally, while young adults are the least likely age group to have visited a dentist in the past year, they are the age group most likely to have received an HIV test within the past year.

Approximately one-quarter of young adults 18-29 years (24.3%) smokes cigarettes, which is similar with the percentage of adults 30-49 years (22.8%) and adults 50-64 years (21.2%), but higher than the percentage of adults 65 years or older (11.2%).

One-third of young adults (33.1%) is physically active less than three days a week, compared with adults 30-49 years (37.8%), adults 50-64 years (41.0%), and adults 65 years or older (47.4%).

Approximately one in seven young adults (14.6%) eats five or more servings of fruits and vegetables a day, which is similar with the percentage of adults 30-49 years (16.0%), adults 50-64 years (16.5%), and adults 65 years or older (15.0%).

Nearly two-fifths of young adults (38.0%) have not been to a dentist in the past year, compared with adults 30-49 years (28.4%), adults 50-64 years (26.7%), and adults 65 years or older (32.3%).

Nearly two-fifths of young adults (39.1%) have had an HIV test within the past year, compared with adults 30-49 years (25.9%), adults 50-64 years (14.7%), and adults 65 years or older (8.9%).

Neighborhood, Housing, and Commuting

In SEPA, young adults are less likely to express favorable views of their neighbors. Young adults are more likely than other adults to rent their home or to use public transportation to get to work.

More than one-third of young adults 18-29 years has feelings of distrust of their neighbors (34.5%), compared with adults 30-49 years (20.3%), adults 50-64 years (16.5%), and adults 65 years or older (10.4%).

• Among young adults, more than one-half of black young adults (53.1%) and Latino young adults (51.2%) have feelings of distrust of their neighbors, compared with one-third of Asian young adults (33.7%) and nearly one-quarter of white young adults (22.5%).

Young adults are less likely to feel they belong in their neighborhood (18.5%), compared with adults 30-49 years (11.4%), adults 50-64 years (10.3%), and adults 65 years or older (5.6%).

Young adults are more likely to rent their home (49.7%), compared with adults 30-49 years (26.9%), adults 50-64 years (15.1%), and adults 65 years or older (16.1%).

Among employed adults, nearly one-fifth of young adults (19.0%) took public transportation to get to work in the past week, compared with adults 30-49 years (12.6%), adults 50-64 years (9.7%), and adults 65 years or older (6.0%).

Summary

Findings from the 2010 Household Health Survey indicate young adults are less connected to the healthcare system than any other age group, as young adults are less likely to have health insurance, prescription drug coverage, or a regular source of care compared with adults 30 years of age or older. Young adults are also more likely than any other age group to have experienced cost barriers to receiving healthcare within the past year. Additionally, survey findings reveal insurance and access to care disparities exist among the young adult population.

For more information about the findings presented in this article, please contact Nicole Dreisbach at nicoled@phmc.org.

Sources: Collins SR, Nicholson JL. Rite of Passage: Young Adults and the Affordable Care Act of 2010. The Commonwealth Fund, 2010. Available at: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2010/May/1404_Collins_rite_of_passage_2010_v3.pdf.