abstract: 'Background: Empirical studies have used a piecemeal approach to the

  examination of health, health care-seeking, uninsured people and the

  health status of those who are chronically ill, but no study emerged in

  an extensive literature search, on the developing nations, and in

  particular Latin America and the Caribbean, that has investigated health

  and health care-seeking behaviour among uninsured ill people in a single

  research.

  Aims: The current study aims to narrow this divide by investigating

  health, self-reported diagnosed health conditions, and health

  care-seeking behaviour among uninsured ill Jamaicans, and to model

  factors which account for their moderate-to-very good health status as

  well as health care-seeking behaviour.

  Methods and materials: The current study utilises cross-sectional survey

  data on Jamaicans which was collected in 2007. The survey is a

  modification of the World Bank''s Living Standard Household Survey. This

  work extracted a sample of 736 respondents who indicated that they were

  ill and uninsured from a sample of 6,783 respondents. Logistic

  regression analyses examined 1) the relationship between

  moderate-to-very good health status and some socio-demographic, economic

  and biological variables; as well as 2) a correlation between medical

  care-seeking behaviour and some socio-demographic, economic and

  biological variables.

  Results: Sixty out of every 100 uninsured ill Jamaicans were females; 43

  out of every 100 were poor; 59 out of every 100 uninsured ill persons

  dwelled in rural areas; 1 of every 2 utilised public health care

  facilities, two-thirds had chronic health conditions, and 22 out of

  every 100 reported at least poor health. Moderate-to-very good health

  status was correlated with age (OR = 0.97, 95\% CI = 0.95-0.98); male

  (OR = 0.60, 95\% CI = 0.37-0.97); middle class (OR = 0.45, 95\% CI =

  0.21-0.95); logged income (OR = 2.87, 95\% CI = 1.50-5.49); area of

  residence (Other Town - OR = 2.33, 95(boolean AND)\% CI = 1.19-4.54;

  Urban - OR = 2.01, 95\% CI = 1.11-3.62), and health care-seeking

  behaviour (OR = 0.45, 95\% CI = 0.27-0.74). Sixty-one of every 100

  uninsured respondents with ill health sought medical care. Medical

  care-seeking behaviour was significantly related to chronic illness (OR

  = 2.25, 95\% CI = 1.31-3.88); age (OR = 1.03, 95\% CI = 1.01-1.04);

  crowding (OR = 1.12, 1.01-1.24); income (OR = 1.00, 95\% CI =

  1.00-1.00); and married people (OR = 0.48, 95\% CI = 0.28-0.82).

  Uninsured ill Jamaicans who resided in rural areas had the lowest

  moderate-to-very good health status, but there was no difference in

  health care-seeking behaviour based on the geographical location of

  residence.

  Conclusion: Despite the fact that there is health insurance coverage

  available for those who are chronically ill and elderly in Jamaica,

  there are still many such people who are without health insurance

  coverage. The task of public health specialists and policy makers is to

  fashion public education and interventions that will address many of the

  realities which emerged in this research.'
affiliation: 'Bourne, PA (Corresponding Author), Univ W Indies, Dept Community Hlth
  Stat, Fac Med Sci, Kingston 7, Jamaica.

  Bourne, Paul Andrew, Univ W Indies, Dept Community Hlth \& Psychiat, Fac Med Sci,
  Kingston 7, Jamaica.'
author: Bourne, Paul Andrew
author-email: paulbourne1@yahoo.com
author_list:
- family: Bourne
  given: Paul Andrew
da: '2023-09-28'
eissn: 1986-8103
files: []
issn: 1840-2291
journal: HEALTHMED
keywords: 'Uninsured; uninsured ill; chronic illness; health status; health

  care-seeking behaviour; health disparity; inequality in health;

  developing nation'
keywords-plus: HEALTH; POVERTY; ILLNESS; INCOME
language: English
number: '3'
number-of-cited-references: '35'
pages: 499-514
papis_id: 2412a1a54bdd363b54108c390ce49161
ref: Bourne2010uninsuredill
researcherid-numbers: Bourne, Paul Andrew/AAE-2714-2022
times-cited: '3'
title: The uninsured ill in a developing nation
type: article
unique-id: WOS:000281882000003
usage-count-last-180-days: '0'
usage-count-since-2013: '4'
volume: '4'
web-of-science-categories: Medicine, General \& Internal
year: '2010'