Limited Access to Health Care and the Impact thereof on Married Women’s Mental Health

Given the rapidly growing population of the have-nots, the rate of unmet medical and mental health needs is expected to increase considerably. According to a recent study using the Korea Health Panel (KHP) survey’s 2011 data, lack of time and money were found to be some of the main reasons for individuals’ failure to seek medical attention. Delayed medical treatment leads to serious health problems, contributing towards limited ability to perform daily functions, which could also result in psychological distress and care burden. This study examined the roles played by income, frequency of problems in daily functioning due to limited access to health care, and frustration in married women’s subjective evaluation of their depression and anxiety. Based on a secondary analysis of the KHP survey’s 2011 data, this study adopted a confirmatory approach in testing a Structural Equation Model (SEM) including these key factors, controlling for subjects’ education level. The sample included 2,764 married women between the ages of 25 and 65 years. Multiple fit indices including the Chi-square statistics (χ²), CMIN/df, the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RMSEA) were used to assess the model fit. The results showed a consistent, satisfactory model fit [(Model χ² (10) = 71.953, p < .01, CMIN/df = 7.1953, CFI = .956, RMSEA = .047)], suggesting a good fit between the proposed model and the data. A CFI value of .956 and an RMSEA value of .047 (.05) indicate a good fit. Based on the model fit indices and path coefficient results, it is fair to conclude that the lower the income, the higher the likelihood (or frequency) of individuals experiencing frustration and daily functional issues associated with unmet medical needs and in turn, experiencing depression and anxiety symptoms or problems. Implications to practice include the need to pay greater attention to low-income families, with regard to their ability to meet their medical needs, so as to further prevent the deterioration of their physical health and mental health. Furthermore, the government ought to assess mental health needs among low-income families with poor physical health given the association between economic status, physical health and mental health.