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August 20, 2019

Report flags regions with high uninsurance rates

A new report out Tuesday flags "priority" areas with the greatest concentrations of people without health insurance in Massachusetts, suggesting strategies to reach those who remain uncovered despite the state's low uninsurance rate of 2.7 percent.

The Blue Cross Blue Shield of Massachusetts Foundation's "Geography of Uninsurance" report compared the state's different zip codes based on their percentage of uninsured residents, number of uninsured residents, and number of uninsured residents per square mile.

The 526 zip codes included in the report had an average of 381 uninsured persons, or 102 per square mile. The report showed regional variations, with a concentration of 667 uninsured people per square mile in the Boston region, 149 in the northeastern portion of the state, and 33 in the western region.

Areas with the greatest concentration of uninsured residents are labeled as "priority hot-spot communities," and the report said they include areas in: Barre, Boston, Chelsea, Everett, Fall River, Framingham, Lawrence, Lowell, Lynn, Malden, New Bedford, Revere, Somerville, Springfield and Worcester.

Fifteen of the 31 priority hot-spot communities are in the Boston region, including 13 within Boston city limits. Among those 31 communities, the average uninsurance rate was 5.8 percent, with an average concentration of 799 uninsured residents per square mile.

Thirty communities had an uninsurance rate of 0 percent, and among the state's different regions, only the Boston region contained no communities with a 0 percent uninsurance rate.

Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation, said the communities with the highest uninsurance rates also tend to "face significant challenges including higher poverty rates and housing costs." She said identifying those areas can help policymakers and community organizations focus their efforts.

"We should be proud of the tremendous progress we have made on increasing the rates of insurance coverage in Massachusetts, but we can't lose track of the fact that there are still communities where those gains in coverage have not been realized," Shelto said in a statement.

Roughly half of uninsured residents in priority hot-spot communities fall in the 18- to 34-years-old age range, nearly two-thirds are male, and more than 40 percent are non-citizens. Thirty percent have incomes below the federal poverty level, according to the report, and more than half would likely be ineligible for health insurance through an employer, either because they did not work in the past year (26 percent) or worked part-time or part-year (37.3 percent).

The foundation's report recommends a series of "targeted outreach strategies" to help the remaining uninsured population in those communities get coverage.

Those strategies include providing enrollment assistance in residents' native languages and developing "strong partnerships" with organizations that serve immigrants and other "trusted local organizations" that have connections to residents of different races, ethnicities and nationalities.

The report also suggested addressing non-medical social needs, such as housing and nutrition, that affect health status.

"For many uninsured residents in the high-priority communities, uninsurance is one of many challenges they face in meeting their basic needs and living well," report co-author Sharon Long, a senior fellow in the Urban Institute's Health Policy Center, said.

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