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Study shows income heavily impacts health care

BY DELTHIA RICKS | delthia.ricks@newsday.com

January 11, 2008

A comprehensive survey that examined adult health and access to medical care on Long Island reveals a region sharply divided along economic lines, with the deepest disparities affecting members of ethnic minority communities.

Led last spring by two researchers at Adelphi University in Garden City, the survey of 1,561 people found that education, income and insurance status held sway over a sweeping range of health outcomes.

Fourteen percent of Long Islanders are so pressured by prescription drug costs, the study found, that they resort to pill-splitting, skipping medication doses or not even bothering to fill prescriptions.

Nearly half of respondents report at least one chronic health problem, and the lower the socioeconomic status, the more likely they reported an ongoing health issue. Even though the region as a whole has a 7 percent rate of type 2 diabetes, black Long Islanders score more than twice that rate, the survey found, at 16 percent.

One-fifth of Hispanics and 26 percent of all residents with household incomes lower than $20,000 a year say they had major problems covering necessities, such as mortgage, rent and food after paying health care costs in the previous year. Surprisingly, 17 percent of those whose incomes range from $49,000 to $60,000 said the same thing.

"It's expensive to live on Long Island," said Suzanne Michael, an assistant professor of social work at Adelphi and a faculty director of Vital Signs, an Adelphi program through which the survey was done. "People have to make decisions, and usually fixed costs like housing are the first things that people pay," Michael said.

With such difficulty paying for basic necessities, added Sarah Eichberg, director of the Vital Signs project, there should be little wonder that health care issues have surfaced.

Expenses are increasingly difficult for many people to cover, the two researchers said yesterday, because medical costs continue to soar and many insurance plans lack medication coverage and payments for other vital forms of care.

"The level of education one has often determines the kind of health care you get," Eichberg said. "Education is a marker for socioeconomic status."

Arthur Gianelli, president and chief executive of Nassau Health Care Corp., called the study a landmark document for Long Island and a road map to structure corrective policies.

"The real meaning for Long Island that as affluent as Nassau and Suffolk are, there are still significant issues with access to health care," said Gianelli. "The study gives us a picture of who lacks access to care, and which demographics and sub-demographics are most affected."

Dr. Cynthia Aranow of the Feinstein Institute for Medical Research attended the news conference at Nassau University Medical Center yesterday during which the findings were released. She said that while the researchers examined many big-picture issues, they failed to examine many smaller ones that have had huge impact on the health of minoritites and women.

Poverty and economic status are not the only drivers of poor health, Aranow said.

Autoimmune diseases, which include such disorders as rheumatoid arthritis and lupus, disproportionately affect many sub-populations examined in the survey. The disorders not only require routine medical care, which some people cannot afford, but are medical conditions requiring more federal research dollars, Aranow said.