IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i5p2615-d511296.html
   My bibliography  Save this article

Private Insurance and Mental Health among Older Adults with Multiple Chronic Conditions: A Longitudinal Analysis by Race and Ethnicity

Author

Listed:
  • Hankyung Jun

    (Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA 90007, USA)

  • Emma Aguila

    (Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA 90007, USA)

Abstract

Older adults with multiple chronic conditions have a higher risk than those without multiple conditions of developing a mental health condition. Individuals with both physical and mental conditions face many substantial burdens. Many such individuals also belong to racial and ethnic minority groups. Private insurance coverage can reduce the risks of developing mental illnesses by increasing healthcare utilization and reducing psychological stress related to financial hardship. This study examines the association between private insurance and mental health (i.e., depressive symptoms and cognitive impairment) among older adults in the United States with multiple chronic conditions by race and ethnicity. We apply a multivariate logistic model with individual fixed-effects to 12 waves of the Health and Retirement Study. Among adults with multiple chronic conditions in late middle age nearing entry to Medicare and of all racial and ethnic groups, those without private insurance have a stronger probability of having depressive symptoms. Private insurance and Medicare can mediate the risk of cognitive impairment among non-Hispanic Whites with multiple chronic conditions and among Blacks regardless of the number of chronic conditions. Our study has implications for policies aiming to reduce disparities among individuals coping with multiple chronic conditions.

Suggested Citation

  • Hankyung Jun & Emma Aguila, 2021. "Private Insurance and Mental Health among Older Adults with Multiple Chronic Conditions: A Longitudinal Analysis by Race and Ethnicity," IJERPH, MDPI, vol. 18(5), pages 1-15, March.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2615-:d:511296
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/5/2615/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/18/5/2615/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Maarten Lindeboom & France Portrait & Gerard J. van den Berg, 2002. "An econometric analysis of the mental‐health effects of major events in the life of older individuals," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 505-520, September.
    2. Jeffrey R. Brown & Amy Finkelstein, 2008. "The Interaction of Public and Private Insurance: Medicaid and the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 98(3), pages 1083-1102, June.
    3. SangNam Ahn & Seonghoon Kim & Hongmei Zhang, 2016. "Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support," IJERPH, MDPI, vol. 14(1), pages 1-11, December.
    4. Eileen M CrimminsPhD & Yasuhiko SaitoPhD & Jung Ki KimPhD & Yuan S ZhangMS & Isaac SassonPhD & Mark D HaywardPhD, 2018. "Educational Differences in the Prevalence of Dementia and Life Expectancy with Dementia: Changes from 2000 to 2010," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 73(suppl_1), pages 20-28.
    5. Sudano, Joseph J. & Baker, David W., 2006. "Explaining US racial/ethnic disparities in health declines and mortality in late middle age: The roles of socioeconomic status, health behaviors, and health insurance," Social Science & Medicine, Elsevier, vol. 62(4), pages 909-922, February.
    6. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    7. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    8. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    9. Zeckhauser, Richard, 1970. "Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives," Journal of Economic Theory, Elsevier, vol. 2(1), pages 10-26, March.
    10. Steven G. Prus & Rania Tfaily & Zhiqiu Lin, 2010. "Comparing Racial and Immigrant Health Status and Health Care Access in Later Life in Canada and the United States," Social and Economic Dimensions of an Aging Population Research Papers 280, McMaster University.
    11. Sandra Decker, 2007. "Medicaid physician fees and the quality of medical care of Medicaid patients in the USA," Review of Economics of the Household, Springer, vol. 5(1), pages 95-112, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ponzo, Michela & Scoppa, Vincenzo, 2016. "Cost-Sharing and Use of Health Services in Italy: Evidence from a Fuzzy Regression Discontinuity Design," IZA Discussion Papers 9772, Institute of Labor Economics (IZA).
    2. Ponzo, Michela & Scoppa, Vincenzo, 2021. "Does demand for health services depend on cost-sharing? Evidence from Italy," Economic Modelling, Elsevier, vol. 103(C).
    3. Raj Chetty & Amy Finkelstein, 2012. "Social Insurance: Connecting Theory to Data," NBER Working Papers 18433, National Bureau of Economic Research, Inc.
    4. Liu, Yinan & Zai, Xianhua, 2022. "The Benefits of Medicaid Home and Community-Based Services on Health," GLO Discussion Paper Series 1079, Global Labor Organization (GLO).
    5. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    6. Liu, Yinan & Zai, Xianhua, 2022. "Does Aging at Home Make Older Adults Healthy: Evidence from Medicaid Home and Community-Based Services," GLO Discussion Paper Series 1079 [rev.], Global Labor Organization (GLO), revised 2022.
    7. Miyawaki, Atsushi & Noguchi, Haruko & Kobayashi, Yasuki, 2017. "Impact of medical subsidy disqualification on children's healthcare utilization: A difference-in-differences analysis from Japan," Social Science & Medicine, Elsevier, vol. 191(C), pages 89-98.
    8. Chen, Hua & Ding, Yugang & Wang, Xiangnan & Yang, Yifei, 2023. "The effect of public insurance policy on the private insurance market: New evidence from a quasi-experiment in China," Economic Analysis and Policy, Elsevier, vol. 78(C), pages 937-953.
    9. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    10. Mariacristina De Nardi & Eric French & John Bailey Jones, 2016. "Medicaid Insurance in Old Age," American Economic Review, American Economic Association, vol. 106(11), pages 3480-3520, November.
    11. Jing Dong & Fabrice Smieliauskas & R. Tamara Konetzka, 2019. "Effects of long-term care insurance on financial well-being," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 277-302, April.
    12. Baicker, Katherine & Chernew, Michael E. & Robbins, Jacob A., 2013. "The spillover effects of Medicare managed care: Medicare Advantage and hospital utilization," Journal of Health Economics, Elsevier, vol. 32(6), pages 1289-1300.
    13. Péter Elek & Tamás Molnár & Balázs Váradi, 2019. "The closer the better: does better access to outpatient care prevent hospitalization?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 801-817, August.
    14. Timothy J. Halliday & Randall Q. Akee, 2020. "The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1231-1250, October.
    15. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).
    16. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    17. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    18. Barbaresco, Silvia & Courtemanche, Charles J. & Qi, Yanling, 2015. "Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults," Journal of Health Economics, Elsevier, vol. 40(C), pages 54-68.
    19. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    20. Zhao, Weimin, 2019. "Does health insurance promote people's consumption? New evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 65-86.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2615-:d:511296. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.