Mental Health
Association Between Medicaid Insurance and Poor Mental Health among Insured Adults (18-64 years old) in Washington State: Analysis of BRFSS Data (2018-2019) Hiwot Weldemariam* Ekua-Yaaba Monkah Hiwot Weldemariam Betelhem Muno
Introduction
The prevalence of poor mental health in the United States is substantial, but there are barriers to accessing mental health care. Medicaid insurance, while expanding eligibility to many people, may pose obstacles that limit inaccessibility to services, more so than most forms of private insurance. The primary aim of this study was to investigate the association between Medicaid insurance coverage and recent self-reported poor mental health, both in aggregate and for specific types.
Methods
We used data from the 2018 to 2019 Washington State Behavioral Risk Factor Surveillance System survey. We included a total of 12,739 adults aged 18 to 64 years, and compared the prevalence of poor mental health for 14 or more days within the month preceding the survey between persons enrolled in Medicaid and those who had other forms of health insurance, adjusting for confounders by means of the Mantel-Haenszel method.
Results
The prevalence of poor mental health for more than 14 days during the prior month was 27.9% (N=466) among 1,780 individuals enrolled in Medicaid, which was 2.45 times higher than the corresponding prevalence in persons with other forms of health insurance. The magnitude of the association was similar after adjusting for confounders such age, race and ethnicity, income, and sex.
Conclusion
These data suggest that having Medicaid insurance is associated with poor self-reported mental health. However, the interpretation of the association is uncertain, given the possibility that poor mental health could potentially influence the type of insurance a person has. Conducting longitudinal studies that track individuals over time would offer a more comprehensive understanding of the temporal dynamics between insurance status and mental health outcomes.