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    Health Savings Account Effects on Health and Debt

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    Author
    Hageman, Sally cc
    Advisor
    Shaw, Terry V.
    Date
    2019
    Type
    dissertation
    
    Metadata
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    Abstract
    Title of Dissertation: Health Savings Account Effects on Health and Debt Sally Anne Hageman, Doctor of Philosophy, 2019 Dissertation Directed by: Terry Shaw, Ph.D. More than a decade ago Health Savings Accounts (HSAs) were deemed contrary to social work values and practice (Gorin, 2006). More recent research, however, demonstrated HSAs may help individuals’ access financial resources when encountering financial barriers (Hageman & St. George, 2019). To further examine the potential of HSAs, this study examines HSA effects on health and debt outcomes. Applying the framework of the social determinants of health (Dahlgren & Whitehead, 1991) and the health lifestyles theory (Cockerham, 2005), a subset of 12,686 respondents from three years (2010, 2012, and 2014) of secondary quantitative data from the National Longitudinal Surveys of Youth (NLSY) was drawn. The sample included respondents who answered survey questions about owning an HSA, chronic disease status, health behavior, and health-related debt. Descriptive, bivariate, weighted logistic regression, and generalized estimating equation (GEE) analyses were conducted. Descriptive analyses indicated about 47% of HSA owners were male, 64% were Non-Black/Non-Hispanic race/ethnicity, with an average age of 53.34 (SD=2.26) years old, 99% owned their home, and had an average income of $126,853 (SD=$122,994). About 75% of HSA owners reported they did not have a chronic disease and 70% reported they did not have health-related debt. Weighted logistic regression was conducted to determine if Chronic Disease status was associated with HSA ownership status. Results indicated Chronic Disease status (p=.88) was not significantly associated with owning an HSA. GEE was conducted to determine whether HSA ownership status was associated with respondent debt. Results of the GEE analysis indicated HSA ownership status (p=.76) was not significantly associated with reporting Debt.
    Description
    2019
    Social Work
    University of Maryland, Baltimore
    Ph.D.
    Keyword
    health debt
    health savings accounts
    medical debt
    Chronic Disease
    Medical Savings Accounts
    Social Work
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/11015
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    Theses and Dissertations School of Social Work
    Theses and Dissertations All Schools

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