Ganghui Suh
Ganghui Suh is a 1st year doctoral student in the School of Public Health at Indiana University. His research interests involve patterns of mental health, substance use and deviant behaviors among marginalized and discriminated population groups. He intends to apply social psychological concepts of discrimination and stereotypes and examine their relations to future health outcomes.
Health Insurance Type and Mental Health Service Utilization among Children with Adverse Childhood Experiences
Background: Adverse Childhood Experiences (ACEs) were linked to negative physical and psychological health outcomes during adulthood, including physical and psychological health. Although psychotherapy and pharmacotherapy have shown to be effective, little is known if those who were exposed to ACEs have different therapy utilization tendencies depending on their insurance status and how rurality plays the moderating role in utilization.
Objective: This study investigated the association of public health insurance coverage and the likelihood of utilizing mental health therapies among children with ACEs, compared to those with private and no health insurance coverage. The moderating effect of rurality on the association was examined.
Methods: Data from 1,179 children who had at least one ACE from the 2019 National Health Interview Survey were included in the study. Two weighted logistic regression models were conducted to examine the association between insurance status, and utilization of mental health therapies, controlling for covariates guided by the Andersen Model of Health Care Utilization.
Results: Those with private health insurance coverage were more likely to utilize psychotherapy [OR=1.71; p<.01] and pharmacotherapy [OR=1.62; p<.05] for mental health conditions compared to those with only public health insurance. Rurality was not a significant moderator on the associations.
Conclusions: Children who were exposed to ACEs with government-assisted public health insurance coverage did not utilize mental health services as much as those with private health insurance. Future public health insurance expansion policies should focus on improving therapy utilization among the beneficiaries and enhancing the awareness of mental health service coverage to those in need.
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