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Community Health Data Base
An Information Service of the Philadelphia Health Management Corporation

Can you Afford to Get Sick?
Tuesday. October 9, 2007

Axler, Francine
(215) 985-2521

PHILADELPHIA-- Across the Southeastern Pennsylvania (SEPA) region, the number of people without health care insurance is steadily rising and economic and racial disparities in insurance coverage and access to health care services abound.   Data from the Philadelphia Health Management Corporation’s Community Health Data Base (CHDB) indicate that this growth is consistent with an August 2007 U.S. Census Bureau report that indicates uninsurance rates among adults and children are growing nationally. 


According to the Census report, 47 million Americans (15.8% of the population) are uninsured, an increase of more than two million (15.3%) from 2005. The report also indicates that 8.7 million children (11.7%) have no health care coverage. In 2005, eight million children (10.9%) were uninsured. When the Census Bureau began tracking health insurance status in 1987, the percentage of Americans without health insurance was 12.9%.


CHDB’s Household Health Survey, the largest local health survey in the country, has been tracking regional uninsurance rates for more than 25 years.  Below is a snapshot of health care coverage rates and disparities across the region. (Data for adults covers ages 18-64):


Regional overview: Approximately 228,300 adults (7.7%) are uninsured, compared to 229,800 (7.8%) in 2004, 211,500 (7.3 %) in 2002, and 159,100 (5.7%) in 2000.


Urban compared to suburban: Since 2000, Philadelphia County has had the highest rate of uninsured residents in the region. In 2006, the city had more than twice as many uninsured adults as the other SEPA counties – 137,200 (12%) compared to 91,000 (5%), respectively. In 2004, 15.1% of Philadelphians lacked insurance and 6.0% of their suburban counterparts did. In 2002, 12.6% of Philadelphians were uninsured compared to residents in 6.6% in suburban counties. Two years earlier, 9.6% of Philadelphians had no coverage versus 5.4% of their suburban neighbors.


Disparities in coverage:

·         Race/Ethnicity. Latino adults (27.8%) are more likely to be uninsured, compared to African American (11.8%), white (4.2%), and Asian adults. The rate of uninsurance has increased steadily among Latino adults since 2000, when 18.4% lacked insurance.


Economic. Adults living in poverty are three times more likely to be uninsured, compared to adults living above the poverty line (20.2% and 6.3%, respectively). In 2004, 21% of adults living in poverty were uninsured compared to 8.1% out of poverty. Children living in poverty (10.2% or approximately 14,900) across SEPA are more likely to lack health insurance coverage compared to children not living in poverty (2.7% or approximately 21,600).


Children: The only area where SEPA rates diverge from the national average is among uninsured children. In SEPA, the number of uninsured children is slightly down from 2002. In 2006, 36,600 children (3.9%), between the ages of 0-17, in SEPA were uninsured, compared to 44,200 (4.7%) in 2004. Nationally, 11.7% of children lack insurance in 2006, compared with 10.9% in 2005.


Access to Care

Throughout the five counties of SEPA, many residents lack access to important preventative and other health care services. CHDB recently released information that tracks access to routine health care and assesses the common barriers to health care access. Its 2006 Household Health Survey results indicate that:


Routine care:

·         298, 300 adults (10.1%) in SEPA did not have a regular medical office or place to go when they were sick or wanted advice about their health.

·         Men (13.2%) were more likely than women (7.5%) to lack a regular source of care.

·         Younger adults were less likely to have a regular source of care than older adults.  Among 18-39 year olds, 16.2% had no regular source of care, followed by 40-49 year olds (8.4%), 50-59 year olds (6.6%), 60-74 year olds (5.7%), and those 75 and older (5.3%).

·         Of the five counties in SEPA, Philadelphia had the highest percentage of adults with no regular source of care (11.8%), and Bucks County had the lowest percentage (8.0%).

·         15.2% of adults in SEPA did not have a medical check-up in the last year.


Barriers to routine care:

·        191,700 adults (6.5%) reported canceling a doctor’s visit due to transportation problems. African American (13.4%) and Latino (13.1%) adults were almost four times as likely to experience transportation barriers to care than white adults (3.7%).


·         270, 900 adults (9.2%) did not seek medical care because of prohibitive costs. African American (9.9%) and Latino (15%) adults were more likely than white adults (8.0%) to report cost as a barrier to receiving health care.


·         77,000 (33.8%) of uninsured adults had no regular source of care, compared to 8.1% of insured adults. In addition, uninsured adults were much less likely than insured adults to have visited a doctor in the past year (61.4% and 86.7%, respectively).


For more information on uninsurance and access to care trends throughout SEPA, contact Francine Axler, senior research associate, at 215-985-2521 or  Additional Survey findings are located online at

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PHMC is a non-profit, public health institute that builds healthier communities through partnerships with government, foundations, businesses and other community-based organizations. Conducted every two years, PHMC’s Southeastern Pennsylvania Household Health Survey is the largest local health survey in the country and provides extensive, timely information on more than 13,000 residents in Philadelphia, Bucks, Montgomery, Delaware and Chester Counties. The survey is conducted by PHMC’s Community Health Data Base Project, which is funded by The Pew Charitable Trusts, The William Penn Foundation, The United Way of Southeastern Pennsylvania, and a variety health, government, nonprofit, and academic organizations.