{"id":"https://openalex.org/W7214965228","doi":"https://doi.org/10.64898/2026.09.29.26364306","title":"Associations of Health Insurance, Household Income, and Cost-Related Healthcare Barriers With Routine Medical Checkup Utilization Among U.S. Adults: Evidence From the 2024 BRFSS","display_name":"Associations of Health Insurance, Household Income, and Cost-Related Healthcare Barriers With Routine Medical Checkup Utilization Among U.S. Adults: Evidence From the 2024 BRFSS","publication_year":2026,"publication_date":"2026-09-30","ids":{"openalex":"https://openalex.org/W7214965228","doi":"https://doi.org/10.64898/2026.09.29.26364306"},"language":"en","primary_location":{"id":"doi:10.64898/2026.09.29.26364306","doi":"https://doi.org/10.64898/2026.09.29.26364306","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.29.26364306","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/30/2026.09.29.26364306.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/30/2026.09.29.26364306.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5120480660","display_name":"Chika Nduka Onwuameze","orcid":"https://orcid.org/0009-0003-7403-5249","observed_orcids":["https://orcid.org/0009-0003-7403-5249"]},"institutions":[{"id":"https://openalex.org/I1331244672","display_name":"Illinois Department of Public Health","ror":"https://ror.org/027bk5v43","country_code":"US","type":"government","lineage":["https://openalex.org/I1331244672","https://openalex.org/I4391767654"]},{"id":"https://openalex.org/I152158401","display_name":"Grambling State University","ror":"https://ror.org/05mnb6484","country_code":"US","type":"education","lineage":["https://openalex.org/I152158401","https://openalex.org/I2799628689"]},{"id":"https://openalex.org/I919208787","display_name":"Louisiana Tech University","ror":"https://ror.org/04q9esz89","country_code":"US","type":"education","lineage":["https://openalex.org/I2799628689","https://openalex.org/I919208787"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Chika Onwuameze","raw_affiliation_strings":["Department of Economics and Finance, Louisiana Tech University, Ruston, Louisiana, USA","Department of Public Administration, Grambling State University, Grambling, Louisiana, USA","Illinois Department of Public Health, Illinois, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Economics and Finance, Louisiana Tech University, Ruston, Louisiana, USA","institution_ids":["https://openalex.org/I919208787"]},{"raw_affiliation_string":"Department of Public Administration, Grambling State University, Grambling, Louisiana, USA","institution_ids":["https://openalex.org/I152158401"]},{"raw_affiliation_string":"Illinois Department of Public Health, Illinois, USA","institution_ids":["https://openalex.org/I1331244672"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004016112","display_name":"Ogbonnaya John Nwoha","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1331244672","display_name":"Illinois Department of Public Health","ror":"https://ror.org/027bk5v43","country_code":"US","type":"government","lineage":["https://openalex.org/I1331244672","https://openalex.org/I4391767654"]},{"id":"https://openalex.org/I152158401","display_name":"Grambling State University","ror":"https://ror.org/05mnb6484","country_code":"US","type":"education","lineage":["https://openalex.org/I152158401","https://openalex.org/I2799628689"]},{"id":"https://openalex.org/I919208787","display_name":"Louisiana Tech University","ror":"https://ror.org/04q9esz89","country_code":"US","type":"education","lineage":["https://openalex.org/I2799628689","https://openalex.org/I919208787"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John Nwoha","raw_affiliation_strings":["Department of Economics and Finance, Louisiana Tech University, Ruston, Louisiana, USA","Department of Public Administration, Grambling State University, Grambling, Louisiana, USA","Illinois Department of Public Health, Illinois, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Economics and Finance, Louisiana Tech University, Ruston, Louisiana, USA","institution_ids":["https://openalex.org/I919208787"]},{"raw_affiliation_string":"Department of Public Administration, Grambling State University, Grambling, Louisiana, USA","institution_ids":["https://openalex.org/I152158401"]},{"raw_affiliation_string":"Illinois Department of Public Health, Illinois, USA","institution_ids":["https://openalex.org/I1331244672"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5153576510","display_name":"Godyson Orji","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1331244672","display_name":"Illinois Department of Public Health","ror":"https://ror.org/027bk5v43","country_code":"US","type":"government","lineage":["https://openalex.org/I1331244672","https://openalex.org/I4391767654"]},{"id":"https://openalex.org/I152158401","display_name":"Grambling State University","ror":"https://ror.org/05mnb6484","country_code":"US","type":"education","lineage":["https://openalex.org/I152158401","https://openalex.org/I2799628689"]},{"id":"https://openalex.org/I919208787","display_name":"Louisiana Tech University","ror":"https://ror.org/04q9esz89","country_code":"US","type":"education","lineage":["https://openalex.org/I2799628689","https://openalex.org/I919208787"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Godyson Orji","raw_affiliation_strings":["Department of Economics and Finance, Louisiana Tech University, Ruston, Louisiana, USA","Department of Public Administration, Grambling State University, Grambling, Louisiana, USA","Illinois Department of Public Health, Illinois, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Economics and Finance, Louisiana Tech University, Ruston, Louisiana, USA","institution_ids":["https://openalex.org/I919208787"]},{"raw_affiliation_string":"Department of Public Administration, Grambling State University, Grambling, Louisiana, USA","institution_ids":["https://openalex.org/I152158401"]},{"raw_affiliation_string":"Illinois Department of Public Health, Illinois, USA","institution_ids":["https://openalex.org/I1331244672"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5120480660"],"corresponding_institution_ids":["https://openalex.org/I1331244672","https://openalex.org/I152158401","https://openalex.org/I919208787"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.7515000104904175,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.7515000104904175,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T14212","display_name":"Health Promotion and Cardiovascular Prevention","score":0.08820000290870667,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10235","display_name":"Health disparities and outcomes","score":0.0778999999165535,"subfield":{"id":"https://openalex.org/subfields/3306","display_name":"Health"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/health-insurance","display_name":"health insurance","score":0.6079999804496765},{"id":"https://openalex.org/keywords/household-income","display_name":"household income","score":0.890999972820282},{"id":"https://openalex.org/keywords/uninsurance","display_name":"uninsurance","score":0.8420000076293945},{"id":"https://openalex.org/keywords/health-care-utilization","display_name":"health care utilization","score":0.8529999852180481},{"id":"https://openalex.org/keywords/preventive-care","display_name":"preventive medicine","score":0.722000002861023},{"id":"https://openalex.org/keywords/brfss","display_name":"Behavioral Risk Factor Surveillance System","score":0.8460000157356262}],"concepts":[{"id":"https://openalex.org/C2777126965","wikidata":"https://www.wikidata.org/wiki/Q4880710","display_name":"Behavioral Risk Factor Surveillance System","level":3,"score":0.8335000276565552},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8082000017166138},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.7164999842643738},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.6802999973297119},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.6391000151634216},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.6316999793052673},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.6220999956130981},{"id":"https://openalex.org/C2778979077","wikidata":"https://www.wikidata.org/wiki/Q330190","display_name":"Receipt","level":2,"score":0.6150000095367432},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5580000281333923},{"id":"https://openalex.org/C39896193","wikidata":"https://www.wikidata.org/wiki/Q380344","display_name":"Descriptive statistics","level":2,"score":0.4846999943256378},{"id":"https://openalex.org/C2983635472","wikidata":"https://www.wikidata.org/wiki/Q334911","display_name":"Health insurance","level":3,"score":0.3862000107765198},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.37779998779296875},{"id":"https://openalex.org/C142546437","wikidata":"https://www.wikidata.org/wiki/Q2661195","display_name":"Descriptive research","level":2,"score":0.36250001192092896},{"id":"https://openalex.org/C2780777579","wikidata":"https://www.wikidata.org/wiki/Q6806347","display_name":"Medical Expenditure Panel Survey","level":4,"score":0.33799999952316284},{"id":"https://openalex.org/C2780128664","wikidata":"https://www.wikidata.org/wiki/Q6973004","display_name":"National Health Interview Survey","level":3,"score":0.3328999876976013},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3131999969482422},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.27720001339912415},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.27410000562667847},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.2689000070095062},{"id":"https://openalex.org/C68443243","wikidata":"https://www.wikidata.org/wiki/Q2786686","display_name":"Quartile","level":3,"score":0.26010000705718994},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2590000033378601},{"id":"https://openalex.org/C198531522","wikidata":"https://www.wikidata.org/wiki/Q485146","display_name":"Sample (material)","level":2,"score":0.25780001282691956},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.2531000077724457}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.09.29.26364306","doi":"https://doi.org/10.64898/2026.09.29.26364306","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.29.26364306","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/30/2026.09.29.26364306.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.09.29.26364306","doi":"https://doi.org/10.64898/2026.09.29.26364306","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.29.26364306","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/30/2026.09.29.26364306.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.98580002784729,"display_name":"Good health and well-being"},{"id":"https://metadata.un.org/sdg/10","score":0.8974000215530396,"display_name":"Reduced inequalities"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7214965228.pdf","grobid_xml":"https://content.openalex.org/works/W7214965228.grobid-xml"},"referenced_works_count":7,"referenced_works":["https://openalex.org/W1832462761","https://openalex.org/W2046363656","https://openalex.org/W2102905683","https://openalex.org/W3175121688","https://openalex.org/W4391486335","https://openalex.org/W4402624767","https://openalex.org/W4403338803"],"related_works":["https://openalex.org/W4412373844","https://openalex.org/W2572214035","https://openalex.org/W2155048347","https://openalex.org/W2419453876","https://openalex.org/W2803690468","https://openalex.org/W4403338803","https://openalex.org/W2793313768","https://openalex.org/W2245816351","https://openalex.org/W4230001988","https://openalex.org/W2186522085"],"abstract_inverted_index":{"Abstract":[0],"Objective":[1],"To":[2],"examine":[3],"associations":[4],"of":[5,17,70,115],"health":[6],"insurance":[7],"status,":[8],"household":[9],"income,":[10,121],"and":[11,40,48,90,122,136],"cost-related":[12],"healthcare":[13],"barriers":[14,79,125],"with":[15,99,113,129],"receipt":[16],"a":[18,55,74],"routine":[19,56,76,130],"medical":[20,57],"checkup":[21,58,101,131],"among":[22],"U.S.":[23,71],"adults.":[24],"Methods":[25],"This":[26],"cross-sectional":[27],"study":[28],"analyzed":[29],"2024":[30],"Behavioral":[31],"Risk":[32],"Factor":[33],"Surveillance":[34],"System":[35],"data.":[36],"Survey-weighted":[37],"descriptive":[38,135],"estimates":[39],"multivariable":[41],"logistic":[42],"regression":[43],"incorporated":[44],"sampling":[45,50],"weights,":[46],"strata,":[47],"primary":[49],"units.":[51],"The":[52],"outcome":[53],"was":[54],"within":[59],"the":[60],"previous":[61],"12":[62],"months.":[63],"Results":[64],"Among":[65],"321,592":[66],"complete":[67],"cases,":[68],"78.0%":[69],"adults":[72,112],"reported":[73,123],"recent":[75],"checkup.":[77],"Cost-related":[78],"(adjusted":[80],"odds":[81,110],"ratio":[82],"[AOR],":[83],"0.56;":[84],"95%":[85,94],"confidence":[86],"interval":[87],"[CI],":[88],"0.54-0.57)":[89],"uninsurance":[91],"(AOR,":[92],"0.28;":[93],"CI,":[95],"0.27-0.29)":[96],"were":[97,126],"associated":[98,128],"lower":[100,108],"utilization.":[102,132],"Lower":[103],"household-income":[104],"groups":[105],"generally":[106],"had":[107],"adjusted":[109],"than":[111],"incomes":[114],"$200,000":[116],"or":[117],"more.":[118],"Conclusions":[119],"Insurance,":[120],"cost":[124],"independently":[127],"Findings":[133],"are":[134],"do":[137],"not":[138],"establish":[139],"causal":[140],"effects.":[141]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-01T00:00:00"}
