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Access to clinical care is necessary to maintain good health, identify and treat health problems at early stages, and manage chronic disease appropriately. Timely access to a dedicated health care provider is linked to better health outcomes, and obtaining recommended preventive screenings can reduce mortality from chronic diseases like cancer.
This report includes six measures of clinical care which intend to broadly capture access to and utilization of care across primary and preventive services as well as oral and mental health services. New to the 2018 Edition, is a measure on mental health treatment, measured as the percentage of persons with any mental illness who received mental health treatment in the past 12 months, such as inpatient care, outpatient care, or prescription medications prescribed to treat a mental or emotional condition.
Across five of the six measures, those who have served consistently report better access to and utilization of clinical care services than those who have not served. Rates of colorectal cancer screening (72.4% vs. 66.0%), dental visit (69.6% vs. 65.2%), flu vaccine (50.6% vs. 37.0%), and mental health treatment (50.8% vs. 42.4%) are significantly higher among those who have served than those who have not. Unmet medical need—measured as the percentage who delay or forgo needed care anytime during the past year due to cost—was significantly lower among those with service than those without (8.7% vs. 14.1%).
Despite having greater access to and uptake of many preventive and clinical care services, those who have served have a significantly lower overall rate of having a dedicated health care provider than those who have not served (75.2% vs. 77.1%).
Rates of having a dedicated health care provider vary significantly between those who have and have not served at the subpopulation level. Of note:
  • Whites (75.0% vs. 80.7%) and Asians (75.0% vs. 80.5%) who have served have significantly lower rates of having a dedicated health care provider than whites and Asians who have not served.
  • Hispanics who have served have a significantly higher rate of having a dedicated health care provider than Hispanics who have not served (73.8% vs. 65.0%).
  • At higher levels of education and income, those who have served have significantly lower rates of having a health care provider than those who have not served. For example, whereas 78.8% of those who have served who earn $75,000 or more have a dedicated health care provider, 85.0% of those who have not served who earn $75,000 or more have a dedicated health care provider.
Mental health treatment also varies significantly between those who have and have not served at the subpopulation level:
  • Men who have served who have any mental illness have a significantly higher rate of receiving mental health treatment than their peers who have not served (49.0% vs. 32.6%).
  • Blacks (54.0% vs. 28.7%), Hispanics (61.3% vs. 29.4%), and Asians (38.1% vs. 22.8%) who have served have nearly twice the rate of receiving mental health treatment for any mental illness they faced in the past year than their counterparts who have not served.
How Have Clinical Care Rates Changed Since 2011-2012 for Those Who Have Served? Encouraging Improvements: - Those who have served experienced a 20% decline in unmet medical need due to cost since 2011-2012. In particular, 18-25 year olds, blacks, and whites with service experienced a 43%, 28%, and 20% decline, respectively, in unmet medical need. - Rate of mental health treatment among those with any mental illness who have served increased significantly by 23% from 41.2% to 50.8%. Whites and men with service also experienced significant improvements in mental health treatment. Remaining Challenges: - Despite improvements, half of those who have served who had any mental illness in the past year still do not receive needed mental health treatment. And among subpopulation groups, such as Asians who have served, nearly two-thirds still do not receive the mental health treatment they need to address their mental illness.

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