Teen substance abuse, lack of insurance increase the cost to society

by Lesley Politi on December 2, 2008

Teen pregnancy isn’t the only issue affecting the health of youth in the Mid-Willamette Valley. A lack of adequate health insurance and growing substance abuse also threaten the well-being of young people.

No insurance

The majority of uninsured children in Oregon come from families where at least one parent or family member works, and more than half may be eligible for public or private coverage but just don’t have it.

“People don’t stop getting sick when they don’t have insurance,” said Andy Walker, the public health manger for Polk County Public Health Department.

Kids still get sick, and those without insurance are six times more likely to lack a regular doctor or source of care. They’re also three times more likely to be taken to an emergency room or urgent-care clinic.

There are 107,000 uninsured children in Oregon, based on U.S. Census data — that’s more than one in nine kids.

And the Willamette Valley ranks second in Oregon for the number of uninsured residents.

About 17 percent of the people living in Benton, Lane, Linn, Marion and Polk counties, which includes the Salem and Eugene metro areas, have no health insurance.

The Portland-area region, despite its greater population, trails in third.

Ultimately, the neglect of regular and preventative care can lead to an increase in chronic diseases, such as obesity, diabetes and asthma; shorter life spans; and more dental cavities and broken and rotted teeth.

“We’re seeing a lot more problems on the dental side — a lack of prevention,” said Paul Logan, the executive director of Northwest Human Services, which operates low-cost clinics in West Salem and Monmouth.

More people who lack coverage but need care are showing up at his clinic doors, Logan said, and the severity of their illnesses is increasing.

Demands for other health-related services, such as at the Marion County Woman, Infants and Children Nutrition Program, also have increased.

“We’re seeing our numbers are at the highest we’ve ever been,” said David Brown, the Marion County WIC supervisor.

Lack of insurance and the cost of health care also are a bane in the minds of the public.

Top health concerns of area residents include a lack of insurance or access to care, a need for free or low-cost clinics, or the cost of medical care, according to a recent community health assessment survey conducted by Marion County Health Department.

Surveys were made available in three languages — English, Spanish and Russian.

When asked whether they had insurance, 81 percent of those completing the English form and 58 percent filling it out in Russian said “yes.” But the majority — almost 80 percent — of those turning in the Spanish version reported “no.”

That response is consistent with state surveys that have found Hispanic adults and Hispanic children in low-income families are more likely to go without insurance coverage.

Children in low-income families who lack insurance also tend to be in families whose earnings approach the cut-off for eligibility in public insurance programs and who have an employed, but uninsured, parent.

Rates of uninsurance rise as income and education drop, and many of the adults without insurance are employed. Even if they’re lucky enough to work for an employer who does offer a health insurance plan, they may not earn enough to cover the cost of premiums.

And while employers remain the primary source of health insurance in the United States — about 60 percent offer it — the numbers are dropping because of rising costs that businesses pay in premiums.

“That’s been the major decline in coverage in what we’re seeing across the nation is the affordability for businesses, especially small businesses,” said Sean Kolmer, the research manager for the state Office of Health Policy and Research, which conducts surveys and analyzes health policy for Oregon.

The Silverton-based Oregon Center for Public Policy, which researches economic issues, reports a more than7 percent drop since 2000 in the number of children who get their health insurance through their parents’ employer.

Given current economic conditions, the struggle to afford coverage may get worse.

“I think one of the things you’re seeing over the past year is you’re seeing a rise in the cost of people’s basic needs,” said Joy Margheim, an analyst at the Oregon Center for Public Policy, “and families just hit a breaking point of where they have to struggle with decisions of whether they can cover food or they can cover health insurance.”

And when focused on such decisions, it can be hard for adults to navigate the public health system to obtain coverage for themselves or their children.

“Quite frankly, when you have a lot of economic pressures, it becomes hard to manage one more,” Logan said.

And it’s a problem that many say can no longer be ignored, given this familiar argument: Less insurance means less access to preventative care, which means people get sicker and cost the health-care system more — a price that gets passed along as increases in premiums and services to healthier consumers.

“Everybody in one way or another pays for the uninsured already,” Walker said. “Society pays for it in having a less healthy population in general.”

— Susie Bodman

Source: www.statesmanjournal.com

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