Research Studies

Health Behaviors and Related Disparities of Insured Adults with a Health Care Provider in the United States, 2015–2016

Research Studies


  • Adults with insurance and provider are not engaging in recommended health behaviors.
  • Disparities in health behaviors related to social factors exist among this group.
  • Socioeconomic status factors are associated with receipt of screenings among this group.
  • Adults with insurance and provider are not receiving influenza vaccination.
  • Adults with insurance and provider are overweight and obese.


Hughes, M. C., Baker, T. A., Kim, H., Valdes, E. G. (2019). Health behaviors and related disparities of insured adults with a health care provider in the United States, 2015–2016. Preventive Medicine, 120, 42-49. DOI: 10.1016/j.ypmed.2019.01.004

Read more about this research


M. Courtney Hughes PhD, MS

Senior Researcher, Relias

Tamara A. Baker

Contributor, Relias Institute

Hansol Kim

Contributor, Relias Institute

Elise Valdes PhD, MS

Director of Research, Relias


Preventive Medicine, March 2019

Research Partner

University of Kansas


Health care providers are in a unique position to address patients’ health behaviors and social determinants of health, factors like income and social support that can significantly impact health. There is a need to better understand the risk behaviors of a population that providers may counsel (i.e., those who are insured and have a provider.) Using the 2015 and 2016 CDC’s Behavioral Risk Factor Surveillance System, we examine the prevalence of health behaviors and the existence of disparities in health behaviors based on social determinants among American adults. Our sample included noninstitutionalized adults aged 18 to 64 years, in the U.S. (N > 300,000). We used multivariate logistic regression analysis to assess the independent effects of income, education, sex, race, and metropolitan status on nine key health behaviors.

Among adults with insurance and a provider (n > 200,000): 1) rates of engaging in poor health behaviors ranged from 6.4% (heavy drinking) to 68.1% (being overweight or obese), 2) rural residence, lower income, and lower education were associated with decreased clinical preventive services, 3) lower income and lower education were associated with lifestyle-related risks, and 4) being black was associated with receiving more cancer screenings, no influenza vaccination, inadequate physical activity, and being overweight or obese.

Insured adults, with a provider, are not meeting recommended guidelines for health behaviors. Significant disparities in health behaviors related to social factors exist among this group. Health care providers and organizations may find it helpful to consider these poor health behaviors and disparities when determining strategies to address SDOH.