Variation in Routine Check-Up Utilization by Working Age Adults: SES or Healthcare Access?

Purpose: Healthy People 2020 aims to reduce health disparities by increasing the utilization of preventive services among American adults. The purpose of this study was to examine the relationships among socioeconomic status (SES), healthcare access, and routine check-ups in a representative sample of working-age adults. Methods: This cross-sectional analysis used 2013 BRFSS data for 35-54 year-old adults in New Jersey. Multiple logistic regression analyses were conducted separately for males and females to determine whether SES (income, education, and employment) and/or healthcare access (healthcare coverage and healthcare cost) predict routine check-up, while controlling for age, race/ethnicity, marital status, and general health. Results: The majority of participants reported having a routine check-up within the past year. None of the SES variables were related to routine check-ups for males or females in unadjusted or adjusted analyses, but the variables for healthcare access were. Routine checkups were 3.53 times more likely for males and 3.77 times more likely for females with healthcare coverage, and 1.41 times less likely for males and 1.47 times less likely for females (OR=.68; 95% CI=.51, .91) with healthcare cost barriers. Conclusions: These findings suggest that healthcare access, not SES, is related to routine check-ups in a representative sample of working aged adults. Therefore, increasing utilization of preventative services among American working age adults may be tied to expanding healthcare coverage and/or providing widespread access to reduced or no cost routine checkups.