January 2015

Overview

Access to health services affects a person’s health and well-being. With regular and reliable access to health services, individuals can help prevent disease and disability, detect and treat illnesses or other conditions, increase their quality of life, reduce their likelihood of premature death, and increase their life expectancy.¹

Lack of medical insurance and access to a usual primary care provider are 2 significant barriers that may impact a person’s regular use of health services. As a consequence, chronic conditions, such as diabetes and heart disease, may remain undiagnosed or be poorly managed, increasing the likelihood of health complications.

Access to health services in rural areas is a particular challenge since this population is disproportionately older, chronically ill, of lower income, and uninsured compared to people living in urban areas.² Additionally, residents of rural communities generally must travel longer distances to providers and may have limited emergency medical services nearby. In 2008, rural counties had on average 62.0 primary care physicians per 100,000 residents, compared to 79.5 per 100,000 for residents of urban areas.³ In 2011, 65% of primary care health professional shortage areas were in rural counties.⁴

Learn More About Access to Health Services

Access to Health Services and the Affordable Care Act

With the implementation of the Affordable Care Act, millions more Americans now have increased access to quality health services. Under the Affordable Care Act, most health plans must now cover a set of 10 essential health benefit categories. This includes important recommended preventive services for adults, women, and children at no cost to the patient, including blood pressure screening and immunizations. Estimates have shown that 76 million Americans became newly eligible for expanded preventive services under the ACA. This means that many more Americans have access to the services they need to keep them healthy. To learn more about accessing quality health services through the Health Insurance Marketplace, please visit healthcare.gov.

Leading Health Indicators

Leading Health Indicators (LHI) are critical health issues that – if tackled appropriately – will dramatically reduce the leading causes of death and preventable illnesses. The Access to Health Services LHIs are:

• Persons with medical insurance
• Persons with a usual primary care provider

Where We’ve Been and Where We’re Going

Over the past decade, the rate of persons aged less than 65 years with health insurance has decreased slightly, from 83.5% in 2003 to 83.3% in 2013; this change was not statistically significant. The proportion of persons with a usual primary care provider also decreased, moving from 77.5% in 2001 to 77.3% in 2011; this change was also not statistically significant. Differences in rates of health insurance exist by race and ethnicity, level of educational attainment, and in the proportion of persons with a usual primary care provider by race and ethnicity, level of educational attainment, and type of insurance.

Who’s Leading the Leading Health Indicators?

Delta Rural Access Program: Increasing Access to Preventive Health Care in Western Alabama

Residents of the rural areas of western Alabama struggle to access health services due to high unemployment rates, lack of transportation, limited access to computers or the internet, inability to pay premiums, and inability to interpret health care information due to literacy issues. In 2014, in the 18-county Delta region of western Alabama, 15% of the population was uninsured. To address these barriers for communities in western Alabama, Tombigbee Healthcare Authority (THA) provides a wide spectrum of health care options for its residents, including community access to preventive care services and resources in a number of settings, such as schools, churches, community centers, homes, and other community outlets. 3Specifically, the Delta Rural Access Program (DRAP) provides preventive services for individuals at risk of developing chronic health conditions and increases access to prescription drugs for residents in the Delta region. DRAP activities include health insurance outreach and enrollment activities, diabetes prevention classes and case management, education campaigns, health screenings, and pharmacy assistance.

The high poverty rates of residents and inaccessibility of health care providers in the Delta region lead to unmet health needs, particularly in terms of diabetes prevention and management among the African-American population. DRAP has implemented the National Diabetes Education Program (NDEP) curriculum, Power to Prevent: A Family Lifestyle Approach to Diabetes Prevention, to address the barriers to accessing preventive health care by targeting those at risk of developing diabetes. The Power to Prevent curriculum is composed of 12 sessions designed to prevent or delay the onset of Type 2 diabetes by promoting lifestyle changes, such as eating a lower calorie diet and increasing physical activity.

Read the Full Story

Leading Health Indicator Infographic

¹ http://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Access-to-Health-Services

² http://www.hrsa.gov/advisorycommittees/rural/publications/ruralimplications.pdf [PDF - 111 KB]

³ National Center for Health Workforce Analysis, Health Resources and Services Administration. Analysis of Area Resource File and the 2008 American Medical Association Physician Masterfile. Available from: http://www.hrsa.gov/advisorycommittees/rural/publications/wpacaprimarycareprovisions092011.pdf [PDF - 106 KB]

⁴ Office of Shortage Designation, Bureau of Health Professions, Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services. Designated Health Profession Shortage Area (HPSA) Statistics [cited 2011 August 11]. Available from: http://datawarehouse.hrsa.gov/topics/shortageAreas.aspx

Reference in this bulletin to any specific product, process, service, organization, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

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