Uninsured Rates, Behavior and Mental Health

Healthy People 2020 has prioritized mental health and mental disorders stating a goal for the decade to, “Improve mental health through prevention by ensuring access to appropriate, quality mental health services.” Psychiatric disorders are a leading cause of disability in the U.S. and research has shown that individuals who have health insurance are more likely to use one or more types of mental health services (Miller et al., 2016). Research has also shown disparities in mental health service use and adequacy based on race, ethnicity, and socioeconomic factors (Jimenez et al., 2013; Tsai et. al., 2014). Research continues to describe an “urgent” need to address mental health and drug use disorders in the U.S. through increased access and screening (Mokdad et al., 2018Weigel et al., 2019).

Analyzing the Data

The purpose of this analysis is to compare the rates of poor mental health days by rates of health insurance coverage, average number of poor physical health days, employment status, income level, teen birth, and excessive drinking at the county level.

This data is also available in a text-based table format.

Tutorial: Using the Data

Data Sources

County Health Ranking (data released 2020)

Defining the Columns

A blank entry indicates unreported data. A value of zero is a defined value and does not represent unreported data.

State: The abbreviation of the state.

County: The name of the county. County names are listed as provided on the U.S. Census Bureau's list of 2019 FIPS Codes for Counties and County Equivalent Entities.

Percent Uninsured: Percentage of people under age 65 without insurance. The reporting period for this measure is 2017 from the Small Area Health Insurance Estimates (SAHIE) program.

Median Household Income: Median annual household income. The reporting period for this measure is 2018 from the Small Area Income and Poverty Estimates (SAIPE).

Percent Unemployment: Percentage of population ages 16+ unemployed and looking for work. The reporting period for this measure is 2018 from the Bureau of Labor Statistics.

Percent Excessive Drinking: The percentage of adults that report either binge drinking, defined as consuming more than 4 (women) or 5 (men) alcoholic beverages on a single occasion in the past 30 days, or heavy drinking, defined as drinking more than one (women) or 2 (men) drinks per day on average. The reporting period for this measure is 2017. Data is from the Behavioral Risk Factor Surveillance System (BRFSS) survey.

Drug Overdose Deaths per 100,000: The number of deaths due to drug poisoning per 100,000 population. The reporting period for this measure is 2016 through 2018 from the Center for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) mortality data.

Teen Births per 1,000: Number of births per 1,000 female population ages 15-19. The reporting period for this measure is 2012 through 2018 from the National Center for Health Statistics - Natality files.

Avg Poor Mental Health Days per Month: Average number of mentally unhealthy days reported in past 30 days (age-adjusted). The reporting period for this measure is 2017. Data is from the Behavioral Risk Factor Surveillance System (BRFSS) survey.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.