Disability, Health Insurance, and Psychological Distress among US Adults: An Application of the Stress Process

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Structural resources, including access to health insurance, are understudied in relation to the stress process. Disability increases the likelihood of mental health problems, but health insurance may moderate this relationship. We explore health insurance coverage as a moderator of the relationship between disability and psychological distress. A pooled sample from 2008 to 2010 (N = 57,958) was obtained from the Integrated Health Interview Series. Chow tests were performed to assess insurance group differences in the association between disability and distress. Results indicated higher levels of distress associated with disability among uninsured adults compared with their peers with public or private insurance. The strength of the relationship between disability and distress was weaker for persons with public compared with private insurance. As the Affordable Care Act is implemented, decision makers should be aware of the potential for insurance coverage, especially public, to ameliorate secondary conditions such as psychological distress among persons who report a physical disability.

Original languageEnglish (US)
Pages (from-to)164-178
Number of pages15
JournalSociety and Mental Health
Issue number3
StatePublished - Nov 2014

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This manuscript was supported by the Integrated Health Interview Series project at the Minnesota Population Center (NIH grants #R01HD046697 and #R24HD041023).


  • affordable care act
  • disability
  • health insurance
  • psychological distress
  • stress process


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