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S. Todd Callahan, MD, MPH; William O. Cooper, MD, MPH

Arch Pediatr Adolesc Med. 2006;160:178-182.

Objective  To assess health insurance status and health care access of young adults with disabilities attributable to a chronic condition.

Design and Setting  We analyzed data from the National Health Interview Survey from 1999 to 2002. We present bivariate analysis and multiple logistic regression of reported health care access barriers in the United States stratified by health insurance status.

Participants  The study population included 1109 survey respondents with and 22 481 without disabling chronic conditions, aged 19 to 29 years.

Main Outcome Measures  Delayed or unmet health needs owing to cost, no contact with a health professional in the prior year, and no usual source of care.

Results  Thirty-five percent of respondents with and 15% without disabling chronic conditions reported an unmet health care need owing to cost (P<.001). Uninsurance rates for young adults with and without disabling chronic conditions were similar (26% vs 28%, respectively), and uninsurance was significantly associated with unmet health care needs. More than two thirds of uninsured respondents with a disabling chronic condition reported an unmet health need and 45% reported no usual source of care. After adjusting for sociodemographic factors, uninsured young adults with disabling chronic conditions had 8 times greater odds of reporting unmet health care needs and 6 times greater odds of having no usual source of care relative to insured respondents with disabling chronic conditions.

Conclusions  Despite increasing attention to issues of health care transition for young adults with disabling chronic conditions, this study suggests that uninsurance is as common among these young adults as nondisabled peers and is significantly associated with health care access barriers in this population.

Author Affiliations: Division of Adolescent Medicine and Behavioral Science (Dr Callahan), Division of General Pediatrics (Dr Cooper), Child and Adolescent Health Research Unit, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.

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