Only half of US residents use preventive care. How can that change?

Topics: Care Delivery, Access to Care, Preventive Care, Health Care Reform, Insurance, Racial/Ethnic Groups, Federal Government, State Government, Local Government, Health Care Legislation, Public Health

We know the ACA has expanded coverage.  The Obama administration earlier this month announced that 20 million people have gained health plans since the law took effect.

Some experts expect that coverage expansions will improve U.S. residents' health by giving them access to preventive services, which could in turn lead to lower health care spending. But are U.S. residents actually using those preventive services?

Where states stand on health prevention

A new report dives into that question. The report -- called "America's Health Rankings Spotlight: Prevention," from the United Health Foundation, the not-for-profit health advocacy foundation of UnitedHealth Group -- analyzed preventive health measures across all 50 states, including:

  • Access to care;
  • Chronic disease prevention; and
  • Immunization rates.

Overall, the report found that U.S. residents are using preventive health services at half the recommended rate, meaning tens of millions of individuals are missing out on basic preventive care.

The report also found that preventive health inequities exist between different:

  • Education levels;
  • Ethnicities;
  • Income levels;
  • Races; and
  • Regions.

For example, the report noted that a lower share of Hispanic U.S. residents use preventive health services when compared with non-Hispanic blacks and non-Hispanic whites.

In addition, the report found that health care access is an important indicator of preventive care use. According to the report, states with high scores on access to care measures also tended to score high on preventive health measures. The report also noted that states that performed well on preventive health measures tended to also perform well among other measures considered in the study, indicating such states take a holistic approach to health.

Reed Tuckson, an external clinical advisor for United Health Foundation, told American Health Line that the report's findings indicate that "in some ways, we've become almost two Americas" when it comes to U.S. residents' access to preventive health care. The trend, he said, is "pretty concerning."

Addressing disparities

So how can states address these disparities?

Cynthia Holzer, CMO at UnitedHealthcare Community Plan of Massachusetts, in an email to American Health Line wrote, "The fact that Americans are using preventive services at half of the recommended rate is alarming." She added, "Promoting use of basic preventive services is a critical first step in the effort to improve individuals' lives and to help control and reduce overall health care costs overall."

Holzer suggested that states implement "[c]onsumer education campaigns stressing the importance of preventive care." She added that educational efforts also could succeed at the national level if they are done through "culturally sensitive marketing." She noted, "Communication about the importance of preventive services is the key to success."

She said, "There are two issues at play here: coverage and use. People need access to affordable, quality health care coverage that supports individuals in getting the primary care services and education they need."

To address the disparities that exist among various demographics, Tuckson said states need to implement policies and initiatives that work best for them. He noted, "Health care and health policy is local. What works best for one state might not work best for other states. It is vital to solve the problem, but how states do it is up to them."

Tuckson said states should use existing research "to drive locally-focused conversations" about which preventive health and access to care issues are most "threatening" to their communities and then "mobilize local resources" to address those areas of need.

He noted that leadership is key to addressing the issue, saying, "We've got to have our leaders across political leadership, health care providers, and at the community level -- churches, civic associations, fraternities and sororities -- and individuals need to decide whether we live or prematurely die is important to us, and whether we will take action to prevent premature death."

In particular, Tuckson said policymakers should focus most on the "very concerning disparities across populations," such as limited access to care in the Hispanic community. He said policymakers must "recognize that we're going to have to look at everybody and how they're affected, not just aggregate data." Tuckson added, "At the end of the day, when it comes to health, we're all in this together. The more policy leaders focus on that, the better chance we have to protect our own health and that of our children."

by Ashley Fuoco Antonelli, associate editor