Volume 47 | Number 1pt2 | February 2012

Abstract List

Jeffrey T. Kullgren, Catherine G. McLaughlin Ph.D., Nandita Mitra, Katrina Armstrong M.D.


To identify prevalences and predictors of nonfinancial barriers that lead to unmet need or delayed care among adults.

Data Source

2007 Health Tracking Household Survey.

Study Design

Reasons for unmet need or delayed care in the previous 12 months were assigned to one of five dimensions in the enchansky and homas model of access to care. Prevalences of barriers in each nonfinancial dimension were estimated for all adults and for adults with affordability barriers. Multivariable logistic regression models were used to estimate associations between individual, household, and insurance characteristics and barriers in each access dimension.

Principal Findings

Eighteen percent of adults experienced affordability barriers and 21 percent experienced nonfinancial barriers that led to unmet need or delayed care. Two‐thirds of adults with affordability barriers also reported nonfinancial barriers. Young adults, women, individuals with lower incomes, parents, and persons with at least one chronic illness had higher adjusted prevalences of nonfinancial barriers.


Nonfinancial barriers are common reasons for unmet need or delayed care among adults and frequently coincide with affordability barriers. Failure to address nonfinancial barriers may limit the impact of policies that seek to expand access by improving the affordability of health care.