MCDC News and Updates

Map of the Month

Missouri’s Uninsured Population, Before and After ACA

In March 2015, the U.S. Census released the 2013 data collected by the Small Area Health Insurance Estimates Program (SAHIE). The SAHIE data is a valuable reference that provides annual estimates of health insurance coverage for every county in the United States. That year, MCDC published a map showing insurance coverage rates for Missouri counties. The 2013 SAHIE data was of particular interest, as that was the last round collected before the first enrollment period of the Affordable Care Act (ACA, or “Obamacare”).

More than five years have passed since the Affordable Care Act was enacted, and we now have an opportunity to compare rates of uninsured persons across Missouri between 2013 and 2018. These two maps both use SAHIE data and the same value scale. (Note that the 2013 map shown here differs slightly from the one we published in 2015. This is due to a different classification scheme, but the underlying data is the same.)

Uninsured in Missouri, before and after ACA

Taking a look first at the 2013 map, we can see that the percentage of uninsured working adults aged 18-64 in Missouri ranged from a low of 11.6% in St. Charles County to a high of 29,3% in Knox County. All counties in the state had an uninsured working population of 11.6% or greater.

The picture is quite different in 2018. Almost all Missouri counties now have uninsured rates of less than 20%, with many under 15%, especially in the central areas of the state. A few counties in the Kansas City and St. Louis areas have uninsured rates of less than 10%.

More significantly, the number and rates of Missouri’s most-uninsured counties have gone down substantially. In 2013, there were 20 Missouri counties where more than a quarter of the adult population were uninsured. By 2018, there were none.

Despite the differences in uninsured rates over the five-year period, one thing hasn’t changed much: The number of hospitals. In fact, between 2013 and 2018, the number of Missouri counties that lack a hospital increased from 41 to 46, according to the Missouri Hospital Profiles By County list, maintained by the Missouri Department of Health and Senior Services (DHSS).

However, only eight of those counties — Hickory, Knox, McDonald, Morgan, Ozark, Shannon, and Wright — had uninsured populations of 20% or more in 2018. That compares with 15 counties without hospitals that had uninsured populations of 25% or more in 2013. So, the overall picture for access to affordable health care has improved.

In addition, the DHSS list of hospitals does not include smaller facilities such as rural clinics, which can better serve a rural population with higher insured rates.

Map of the Month

Food Insecurity for Missouri’s Children

One of the most significant changes to daily life that we’ve seen from Missouri’s response to the Coronavirus is the closure of many public school systems. While no state-level order has been put into action, cities and counties from across Missouri have closed their doors and moved to online education. This, in turn, has brought the topic of childhood food insecurity to the forefront of many discussions across Missouri.

This web map, designed by the Missouri Spatial Data Information Service (MSDIS), illustrates the percentage of children, by county, who are faced with such a challenge. With schools now closed for an unknown amount of time, it is more important than ever to keep the reality of childhood hunger in mind.

Missouri childhood food insecurity

The Missouri Census Data Center frequently works with MSDIS on mapping and data projects. MSDIS is a spatial data retrieval and archival system offering many mapping resources, primarily focused on the state of Missouri.

Map of the Month

Missourians Over 60 and Local Healthcare Resources

As the Coronavirus becomes a global threat, older Missourians are increasingly at risk of contracting this potent disease. This web map, designed by the Missouri Spatial Data Information Service (MSDIS), features county-level demographic data from the Missouri Census Data Center that highlights Missouri’s over-60 population, as well as several datasets from the Missouri Department of Health and Senior Services that highlight some of the healthcare resources that are available to them.

Missourians over 60
The Missouri Census Data Center frequently works with MSDIS on mapping and data projects. MSDIS is a spatial data retrieval and archival system offering many mapping resources, primarily focused on the state of Missouri.

Map of the Month

Hospital Availability and Uninsured Population in Missouri

In March 2015, the U.S. Census released the 2013 data collected by the Small Area Health Insurance Estimates Program (SAHIE). The SAHIE data is a valuable reference that provides annual estimates of health insurance coverage for every county in the United States. The 2013 SAHIE data is of particular interest, as that was the last round collected before the first enrollment period of the Affordable Care Act.

Hospital availability and estimated uninsured population in Missouri, 2013

Based on the SAHIE 2013 county-level data, the percentage of uninsured working adults aged 18-64 in Missouri ranged from a low of 11.6% in St. Charles County to a high of 29% in Knox County. This information is interesting in and of itself, as it indicates that no Missouri county had an uninsured working population of 10% or less. When combined with the locations of Missouri hospitals, though, the SAHIE data presents an important lesson.

According to the Missouri Hospital Profiles By Name list, maintained by the Missouri Dept of Health and Senior Services, 41 Missouri counties do not have a hospital within their administrative boundaries. Combining that information with the SAHIE’s estimates reveals that 15 of those counties — Benton, Carter, Daviess, Douglas, Hickory, Knox, McDonald, Morgan, Oregon, Ozark, Schuyler, Shannon, Stone, Webster, and Wright — had uninsured populations between 25.1% and 29% in 2013. Although the list of hospitals does not include smaller facilities (such as rural clinics), this overlap does strongly suggest that some of Missouri’s most medically underserved counties were also home to very high numbers of uninsured working adults.

Reference: U.S. Census report on 2013 SAHIE