The effect of health insurance coverage and the doctor-patient relationship on health care utilization in high poverty neighborhoods

- The effect of health insurance on testing for cardiovascular disease is examined.
- Health insurance increases the odds of being tested.
- Having a regular health care provider mediates the effect of insurance on testing.
- The mediation is greatest when the patient can report the doctor's name.

African Americans have higher rates of mortality than whites who are the same age and sex. We hypothesize that in low socioeconomic status neighborhoods, having health insurance coverage and a regular health care provider increases the likelihood of receiving diagnostic tests for cardiovascular disease and diabetes. We use data from a random two-stage cluster sample of 230 adults living in high poverty census tracts to examine the effects of insurance coverage and having a regular doctor on the likelihood receiving diagnostic tests for high cholesterol, high blood sugar, and blood pressure. We find that health insurance coverage increases the odds of having a regular health care provider (p < 0.05) and of receiving the diagnostic tests (p < 0.05). Having a regular doctor mediates the effect of insurance coverage on the likelihood of receiving the tests, especially when the participant can report the physician's name.