The latest compilation of U.S. Census figures confirms the embarrassing truth about our health care system, that the poorest and sickest often get the least basic care like checkups and dental exams.

The findings come from a report titled Health Status, Health Insurance and Medical Services Utilization: 2010. The good news is that two thirds of Americans feel their health is excellent or very good.

The bad news is that over the past 10 years more Americans have lost health care insurance and are making fewer visits to doctors, dentists, nurses and other health care providers.

Working-age Americans (18-64), made an average of 3.9 visits to medical providers in 2010 compared to 4.8 visits in 2001.

Among those adults who reported that their health was either fair or poor, the average number of annual visits dropped from 12.9 to 11.6 over the 10-year period.

People without insurance, according to the report, are less likely to visit a doctor. In 2010, 17 percent of Americans had no health insurance while that number has risen to 21.7 percent in 2010.

The reduced number of visits is likely the result of fewer people having health insurance while those with health insurance are facing higher deductibles and premiums combined with medical costs that have risen far faster than incomes.

Race and income continue to influence how many health care visits people make.

Whites were the most likely to have had at least one medical provider visit in 2010 (77.2 percent). They were also the most likely to report being in good or excellent health.

Blacks were less likely to have at least one visit (70.3 percent) and Hispanics were the least likely of all (57.7) percent.

Part of the difference can be attributed to demographics. Young people are less likely to visit a doctor and Hispanics are, on average, younger than whites or blacks.

But other Census numbers show income also determines how much medical and dental care people receive and how likely they are to take prescription drugs.

“Among people in poverty, 38.6 percent went without seeing a medical provider in the previous 12 months compared to 19.1 percent of those whose family income was greater than or equal to 400 percent of the poverty threshold.”

Basic dental care is even more a function of income.

More than half of those in poverty (57.4 percent) did not visit a dentist in the past year, while only a quarter (26.1 percent) of the highest income group failed to see a dentist.

The same goes for access to prescription drugs.

“Among people who were in poverty, 65.8 percent reported never having taken medication in the previous year, compared to 52.2 percent of people whose family income was at least 400 percent of the poverty threshold.”

Sadly, the Census Bureau survey found a negative relationship between health status and insurance coverage.

“People with poor, fair, or good health were more likely to be uninsured (23.4, 25.2 and 24.4 percent respectively) than those with very good or excellent health (20.1 and 15.6 percent).”

And, naturally, a high family income usually means people have health care insurance through their work or can pay for it on their own.

The overall picture that emerges is of an uneven health care system that provides more dependable care for those who have insurance, good health and higher incomes.

While the system is less available to the poorest and sickest.

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