Yes - and Hawaii is a distinct outlier in Kawachi / Kennedy / Subramanian
SV,
Ann Pobutsky wrote:
[log in to unmask]" type="cite">Diana:
Hawaii did pass the Prepaid HealthCare Act (1980's) which required
employers to provide health insurance to employed people working more
than 20 hours per week...so Hawaii does have higher health insurance
coverage compared to many other states.
But this all depends on the economy and when we have setbacks (like
right now and in the 1990's), you find the uninsured rate going up
(employers hire more part-timers etc).
The kids in Hawaii are all basically covered in the CHIP-Children's
Health Insurance Program (Medicaid).
But having health insurance doesn't stop the disparities....we have
on-going and persistent disparities (premature mortality) among
(espeically) Native Hawaiians and other Pacific Islanders, Filipinos,
low SES folks and rural areas...biggest mediating factor is
socio-economic circumstances.
Our state chronic disease rates are low when comparing nationally
(.e.g. we are in the top 5 states along with Colorado etc. for lowest
obesity rates) but once you start to get in to the details, the
disparities start to emerge Big Time.
So mandating employers to pay doesn't cover everyone because of the
loopholes and having insurance and 'access to care' doesn't eliminate
disparities.
Ann P.
----- Original Message -----
From: Diana Liu <[log in to unmask]>
Date: Tuesday, July 1, 2008 4:31 pm
Subject: Re: Fwd:Re: [SDOH] -Any articles/infor will help
To: [log in to unmask]
>
My understanding is that Hawaii has Statewide Universal Health
Care. Do you see a decreased health disparities compared with other
States? It would be very interesting to hear your experience.
>
Date: Tue, 1 Jul 2008 14:43:22 -1000
>
From: Ann Pobutsky <[log in to unmask]>
>
Subject: Re: [SDOH] -Any articles/infor will help
>
To: [log in to unmask]
>
HELP-does anyone have any articles/information I can use to
combat the idea that access to care will eliminate health disparities.
>
Is there some peculiar focus in the U.S. on 'access to care'
as the 'solution'?
>
Ann M. Pobutsky, PhD
>
Chronic Disease Epidemiologist
>
Community Health Division
>
Hawaii State Department of Health
>
1250 Punchbowl St., Rm. 218
--
Alice Furumoto-Dawson, Ph.D.
Sr. Research Associate
Center for Interdisciplinary Health Disparities Research
Institute for Mind & Biology
University of Chicago
Chicago, IL - USA
Email: [log in to unmask]
http://cihdr.uchicago.edu/