Access to Care

Population without Health Insurance

Why this is important: Health insurance coverage can influence whether someone gets the healthcare they need when they need it. Without insurance, people might delay seeking care, which can turn small health problems into big ones, leading to long-term health issues and financial difficulties. People in underserved communities are at higher risk of being uninsured, which can worsen existing health disparities.

Definition: Percent of civilian non-institutionalized residents of all ages who do not have health insurance

Learn more:

• Washington Health Plan Finder https://www.wahealthplanfinder.org
• Statewide Health Insurance Benefits Advisors (SHIBA), WA Office of the Insurance Commissioner.
• The Importance of Health Coverage, American Hospital Association, 2019.
• Key Facts about the Uninsured Population, Kaiser Family Foundation, 2023.

Children without Health Insurance

Why this is important: Children who don’t have health insurance are less likely to see a primary care doctor, dentist, or eye doctor regularly or have a doctor who knows their medical history². As a result, they might not get essential vaccinations and miss out on preventative care, and timely treatment of developmental or health issues. Not having insurance can worsen health disparities among children; therefore, ensuring access to health insurance for all children can provide a better opportunity for healthy development, good health, and overall well-being.

Definition: Percent of civilian non-institutionalized residents age 19 and under who do not have health insurance

Learn more:

• Children’s Health Coverage Programs in Washington, InsureKidsNow.Gov.
• Rate of Uninsured Kids Held Steady Nationwide and Improved in 17 States In 2022, Annie E Casey Foundation, 2023.
• Underinsurance Among Children in the United States, American Academy of Pediatrics, 2021.

Financial Barrier to Healthcare

Why this is important: Many adults who cannot afford to see a doctor face a significant barrier to accessing necessary medical care. This can result in untreated health issues worsening, leading to increased long-term healthcare costs and putting greater economic strain on both individuals and the healthcare system. Even people with health insurance can be unable to afford medical care due to high deductibles, co-pays, or other limitations of their insurance plan.

Definition: Percent of adults who report being unable to see a doctor due to cost in the past 12 months.

Learn more:

• Americans’ Challenges with Health Care Costs, Kaiser Family Foundation, 2024.
• Improving Access to Affordable and Equitable Health Coverage: A Review from 2010 to 2024, US Department of Health and Human Services, 2024.
• Paying for It: How Health Care Costs and Medical Debt Are Making Americans Sicker and Poorer, Commonwealth Fund, 2023.

Adults with a Primary Care Provider

Why this is important: Primary care providers are doctors or other qualified health practitioners who see people for routine, non-emergency care. They provide preventive care, identify and manage common medical conditions, and make referrals to specialists when necessary.  Primary care providers and patients often develop trusting relationships over time, which helps providers become familiar with a person’s health history, recognize new health issues, and understand what is important to them. This continuity of care facilitates patients and primary care providers working together to maintain health and ensure a better quality of life, regardless of health circumstances.

Definition:  Percent of adults who reported having a primary health care provider.

Learn more:

• Access to Primary Care Literature Summary, Healthy People 2030.
• Primary Care in High-Income Countries: How the United States Compares, Commonwealth Fund, 2022. 
• Assessing the Longitudinal Impact of Physician-Patient Relationship on Functional Health, Annals of Family Medicine, 2020.

Primary Care Physician Ratio

Why this is important: The ratio of primary care physicians to residents is one way to measure how available primary care is in a community. Physician availability is crucial as it encourages routine checkups and preventive health screenings. A community’s shortage of primary care providers can lead to delays in receiving necessary healthcare, potentially resulting in more serious health issues. Ensuring an adequate ratio of primary care physicians helps maintain public health and prevent the escalation of minor health problems into major ones.

Definition: Number of residents per primary care physician

Learn more:

• Washington State Primary Care Needs Assessment, Area Health Education Center of Western Washington, 2021.
• Ratio of primary care physicians and prevalence of metabolic syndrome: Health disparities in Washington, WA State Department of Health, 2019.
• Relationship between the presence of primary care physicians and health‐related quality of life, Journal of General and Family Medicine, 2022.

Youth Dental Visits

Why this is important: Regular dental visits for youth are crucial for maintaining oral health and preventing future dental issues. Dental check-ups are pivotal in detecting and treating problems such as cavities or misalignment early and preventing more serious problems later in life. Routine dental visits for young people can ensure healthier teeth and overall well-being as they grow.

Definition: Percent of 10th grade students who report not seeing a dentist in the last 12 months

Learn more:

• Access to Dental Care Dashboard, Arcora Foundation. 
• Washington State Oral Health Data, WA State Department of Health.
• Oral Health Equity Assessment, WA State Department of Health, 2023.

Colon Cancer Screening

Why this is important: Colon cancer is a significant health issue in Washington State, ranking as the second most common cancer and the second highest cause of cancer-related deaths. However, many of these deaths are preventable if caught early through routine screening tests. Various screening methods, including stool tests, sigmoidoscopy, and colonoscopy, are available to detect abnormalities before they progress to cancer. Early detection not only facilitates treatment but also enhances the likelihood of survival⁴, underscoring the importance of regular colon cancer screening initiatives. The Healthy People 2030 national target is 68.3%.

Definition: Percent of adults ages 50–75 who had a blood stool test in the past year, sigmoidoscopy in the past 5 years and a blood stool test in the past 3 years, or colonoscopy in the past 10 years

Learn more:

• Cancer Data, WA State Department of Health.
• Colorectal Cancer Screening, National Cancer Institute.
• Colorectal Cancer, American Cancer Society.
• Colorectal Cancer Screening Recommendation, US Preventive Services Task Force, 2021.

Breast Cancer Screening

Why this is important: Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related deaths among females in Washington State. Mammograms are used to detect tumors, calcifications, and changes in healthy breast tissue. Regular mammogram screenings are crucial for identifying and addressing early-stage breast cancer⁵, and they play a significant role in protecting an individual’s health and improving survival rates. The Healthy People 2030 national target is 80.3%.

Definition: Percent of women ages 50-74 who had a mammogram in the past two years.

Learn more:

• Breast Cancer, WA State Department of Health.
• Breast Cancer Screening, National Cancer Institute.
• Breast Cancer Screening Recommendation, US Preventive Services Task Force, 2024.

Learn more:

• Healthy Pregnancy & Parenting, Whatcom County Health Department.
• Maternity Support Services, Sea Mar Community Health Center.
• Whatcom Perinatal Mental Health Task Force
• Perinatal Data, WA State Department of Health.
• Prenatal Care Checkups, March of Dimes.

Prenatal Care in the First Trimester

Why this is important: Receiving prenatal care in the first trimester can help lay the foundation for a healthy pregnancy, birth, and infancy. During this period, healthcare providers can assess the parent’s physical and mental health and identify additional supports or services that may be needed. Regular monitoring and timely interventions in the first trimester significantly contribute to reducing the risk of complications and ensuring optimal outcomes for both parent and baby.

Definition: Percent of live births for which the birthing parent began prenatal care with a healthcare provider in the first trimester of their pregnancy

Learn more:

• Healthy Pregnancy & Parenting, Whatcom County Health Department.
• Maternity Support Services, Sea Mar Community Health Center.
• Perinatal Data, WA State Department of Health.
• Prenatal Care, March of Dimes.
• Correlates of Early Prenatal Care Access among U.S. Women: Data from the Pregnancy Risk Assessment Monitoring System (PRAMS), Maternal and Child Health Journal, 2022

Well-Child Visits

Why this is important: Well-child visits are critical for monitoring a child’s growth and development and detecting any health or developmental concerns early. Regular check-ups allow healthcare providers to address any issues promptly, provide necessary vaccinations, refer families to additional services if needed, and guide parents in promoting their child’s health and well-being. By taking their children to well-child visits, parents can contribute to their children’s overall health and development, setting a foundation for a lifetime of wellness.

Definition: Percent of Medicaid beneficiaries with six or more well-child visits during their first 15 months of life and two or more well-child visits during their first 15 month to 30 months of life. Percent of Medicaid beneficiaries with six or more well-child visits during their first 15 months of life and two or more well-child visits during their first 15 month to 30 months of life.

Learn more:

• Single Entry Access to Services (SEAS) Program, Whatcom Taking Action.
• Child and Adolescent Well-Care Visits, WA State Department of Health.
• Watch Me Grow Washington, WA State Department of Health.
• Percentage of Children Aged <18 Years Who Received a Well-Child Checkup in the Past 12 Months, Centers for Disease Control and Prevention.

Additional Resources

• Community Checkup