High out-of-pocket medical expenses unsurprisingly are putting a strain on U.S. household budgets. Burdensome medical costs make it harder for households with children to visit physicians, adhere to treatment plans and meet basic needs.
Approximately 4% of U.S. households with children spend 10% or more of their income on out-of-pocket medical expenses, according to a new report in JAMA Network Open. Out-of-pocket spending consumes substantial income shares even among households enrolled in federally subsidized Marketplace, Medicaid or Medicare health insurance programs. Rising health care costs could mean that more households with children experience medical financial burdens this year.
This is having an impact on health-related social needs, which are defined as a household's ability to meet needs for medical care, purchase healthy food, pay bills and live in safe housing. Studies have indicated that individuals who are not able to address these needs may have higher long-term health care costs.
Researchers found that household exposures to out-of-pocket medical financial burdens were associated with an elevated prevalence of food insecurity a year later. The results highlight how health care costs may imperil the wellbeing of households with children. Persistent food insecurity can harm child health. Children experiencing food insecurity are more likely than their peers to exhibit chronic conditions, report poor mental health and visit the emergency department.
Food insecurity also is associated with worse child development and academic outcomes. The inability to access health-related social needs may exacerbate poor health and reinforce the challenges households face paying future medical bills.
Multiple factors may explain why out-of-pocket burdens were significantly associated with food insecurity. Food insecurity is more closely tied to short-term economic insecurity than housing quality. Maintenance deferred during a period of high out-of-pocket spending may contribute to a lagged association between out-of-pocket costs and poor housing quality that does not appear within a year. Because of housing's centrality to daily life, household members may make sacrifices to ensure that rent, mortgage and utilities are paid.
"This cohort study of US households with children found that out-of-pocket medical financial burdens were associated with an elevated odds of food insecurity a year later," the report concluded. "No association was observed between out-of-pocket burdens and difficulty paying bills or poor housing quality. This analysis highlights that out-of-pocket medical spending may be a determinant of household food security. Future research should consider which factors mitigate the association between out-of-pocket medical costs and health-related social needs."
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