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May 20--More women than men delay receiving health care, citing barriers such as time, child-care issues and a lack of insurance.
Of nearly 3,000 women surveyed by the Kaiser Family Foundation, more than a quarter of them -- 26 percent -- delayed care because of cost alone, compared to 20 percent of men. Uninsured women were far more likely to face cost barriers than either insured women or those on Medicaid, according to the study.
The Wellness Coalition works with women ages 19 to 64 without health insurance -- people age 65 and older generally have Medicare -- and with chronic diseases such as diabetes, heart disease, hypertension, obesity and asthma. Cynthia Bisbee, the coalition's executive director, said one reason for the delay is because women tend to put their families ahead of themselves.
"If there is a certain amount of money to go around, they will take care of their children first, ahead of themselves," she said. "Lack of insurance has women putting off going to the doctor because they can't afford it. What we see is the chronic conditions getting out of control, and the women having to head to the emergency room."
Nancy Hogan, executive director at Medical Outreach Ministries, notices the same trend.
She said more than half those who use the ministry on East South Boulevard are women. And all served do not have insurance.
"They are having to choose between paying the bills and buying food for their family, or paying for heat," she said of the women. "Health care went on the back burner. With (Medical Outreach Ministries), they don't have to choose anymore. They are able to get the medications to treat their conditions."
Though women across all income levels said they "couldn't find time" to go to the doctor, poor women were significantly more likely to say that they couldn't get time off work, couldn't get child care, or weren't able to arrange transportation, according to the Kaiser survey.
Class does have a lot to do about whether women seek preventive care, said Denise Davis-Maye, an associate professor of sociology and social work at Auburn Montgomery.
"I am clear that women coming from working-class environments, who do have insurance, don't have the time to take off from work to pursue doctor's appointments," she said. "I don't know that I would call it a delay ... or it not being a priority. If everyone is sick in the house, taking care of others' needs will come first."
About 13 million women will gain insurance coverage because of the Affordable Care Act by 2016, according to the U.S. Department of Health and Human Services. In Alabama, about 247,000 women , more than 16 percent, were uninsured in 2011, according to the State of Women, a partnership of the National Women's Law Center and state partners. More than 18 percent of black women in Alabama and more than 65 percent of Hispanic women were uninsured compared to 12.7 percent of white women.
A lack of insurance, Bisbee said, prevents maintenance care -- routine health care -- and women are not going to pay for something preventive if insurance does not cover it.
"We have a lot of people on insurance that weren't on insurance before," she said, adding that within the state, 97,000 men and women enrolled in health insurance during the open enrollment for the Affordable Care Act from October through the end of March. "We don't yet have the county-level numbers to know what happened in our coverage area."
Women living below 200 percent of the poverty level were also more likely to say that they had a disability or chronic condition that limits their activity level, and they were less likely to have had a recent general check-up, according to the Kaiser survey. Uninsured women (not all of whom are classified as low income) were also less likely to have had screening tests for various chronic conditions.
And when they do make it to Medical Outreach Ministries, the No. 1 diagnosis is for hypertension, followed by diabetes, Hogan said. And, without proper medical care, "we see people come in with their blood pressure incredibly high."
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