A Profile of Community Health Center Patients: Implications for Policy
Data Sources: This analysis uses data from the 2009 Health Center Patient Survey and the 2010 National Health Interview Survey (NHIS). The Health Center Patient Survey is a nationally representative survey of patients served by HRSA-supported community health centers. The survey collects self-reported information on socio-demographic characteristics, access to health care services, health status, utilization of services, and satisfaction and perceived quality of care. In the 2009 survey, 4,562 individuals were surveyed at 347 health center sites.
To compare health center patients to the general population, we relied on the 2010 NHIS, a nationally representative survey of the health, health care access, and health services use of the civilian non-institutionalized population in the United States.1 We used the 2010 NHIS (rather than 2009, the year of the Health Center Patient Survey) because it included more variables of interest for this analysis than the 2009 NHIS. In order to have a national comparison group similar to health center patients, we restrict the NHIS sample to the low-income subpopulation (<200% FPL). The sample size for the 2010 NHIS low-income subpopulation was 31,020.
Analysis. For both the health center patient and NHIS samples, we examined socio-demographic characteristics including income, age, gender, race/ethnicity, language preference, employment status, and insurance status.
To evaluate adult health status, we compared self-perceived health status, report of smoking, and whether the respondent had ever been told that he or she had asthma, diabetes, hypertension, emphysema, liver or heart disease. We also assessed whether respondents had depression or anxiety. In the Health Center Patient Survey, we captured depression and anxiety based on self-reports of whether the respondent had ever had these illnesses in his/her lifetime. In the NHIS, we measured depression and anxiety using questions in the Quality of Life supplement, which is administered to approximately one-quarter of adults in the overall sample. These questions asked respondents who either (i) reported feeling worried, nervous, or anxious at least monthly, or (ii) took medication for those feelings, a follow-up question about whether they had been told by a medical professional that they had anxiety or depression. We used the follow-up question to estimate overall prevalence of depression or anxiety. Last, we measured obesity by calculating each respondent’s body mass index (BMI) based on self-report of height and weight.
We assessed receipt of preventive services based on whether respondents reported receiving routine annual physical and dental exams, as well as cancer screenings appropriate to their age and gender. Last, we measured receipt of follow-up care for women and chronic condition management for respondents with diabetes and hypertension.