The Role of Health Insurance Type and Clinic Visit on Hypertension Status Among Multiethnic Chicago Residents

Am J Health Promot. 2024 Mar;38(3):306-315. doi: 10.1177/08901171231209674. Epub 2023 Oct 25.


Purpose: To investigate the joint relationship of health insurance and clinic visit with hypertension among underserved populations.

Design: Population-based cohort study.

Subjects: Data from 1092 participants from the Chicago Multiethnic Prevention and Surveillance Study (COMPASS) between 2013 and 2020 were analyzed.

Measures: Five health insurance types were included: uninsured, Medicaid, Medicare, private, and other. Clinic visit over past 12 months were retrieved from medical records and categorized into 4 groups: no clinic visit, 1-3 visits, 4-7 visits, >7 visits.

Analysis: Inverse-probability weighted logistic regression was used to estimate odds ratios (OR) and 95% confidence interval (CI) for hypertension status according to health insurance and clinic visit. Models were adjusted for individual socio-demographic variables and medical history.

Results: The study population was predominantly Black (>85%) of low socioeconomic status. Health insurance was not associated with more clinic visit. Measured hypertension was more frequently found in private insurance (OR = 6.48, 95% CI: 1.92-21.85) compared to the uninsured group, while 1-3 clinic visits were associated with less prevalence (OR = .59, 95% CI: .35-1.00) compared to no clinic visit. These associations remained unchanged when health insurance and clinic visit were adjusted for each other.

Conclusion: In this study population, private insurance was associated with higher measured hypertension prevalence compared to no insurance. The associations of health insurance and clinic visit were independent of each other.

Keywords: clinic visit; disease management and prevention; health disparities; health insurance; health policy; health service utilization; hypertension; opportunity; strategies.

MeSH terms

  • Aged
  • Ambulatory Care
  • Chicago / epidemiology
  • Cohort Studies
  • Humans
  • Insurance Coverage*
  • Insurance, Health
  • Medicaid
  • Medically Uninsured
  • Medicare*
  • United States / epidemiology