Date of Award


Document Type

Campus Access Dissertation


Health Services and Policy Management

First Advisor

Saundra H Glover


Objective: This study examines the association of health insurance coverage status and self-reported mental health status within the young adult population of the United States. Additionally, the study determines the prevalence of self-reported psychological distress among the young adult population and among vulnerable sub-groups in the United States. Finally, this study addresses how contextual, individual, and health behavior factors, including health insurance coverage status and life satisfaction are associated with mental health status among young adults within the United States population.

Methods: The estimates in this report were derived from the National Longitudinal Survey of Youth 97, conducted by the Bureau of Labor, Department of Commerce in 2008. Cross-sectional estimates were calculated using the SAS 9.2 statistical package to account for the complex survey design. Descriptive and inferential statistical analysis was conducted on the weighted data.

Results: Within the sample, the estimated prevalence of psychological distress (PD) among young adults within the U.S. population in 2008 was an estimated 11.34%. Those who reported life satisfaction scores of 1 - 5, were more likely to self report PD (COR 14.83; 95% CI, 10.66 - 20.62). The association remained significant in the adjusted analysis. Persons reporting being uninsured (COR 2.04; 95% CI, 1.66 - 2.49) or having partial-year unknown source (COR 2.37; 95% CI, 1.80 - 3.11), or having partial-year government coverage (COR 2.93; 95% CI, 1.84 - 4.67), or classified as full-year government coverage (COR 3.51; 95% CI, 2.74 - 4.50) were more likely to experience PD than full year private coverage. However, the associations were not significant when controlling for covariates. Significant associations were observed between young adults who had military experience, incarceration experience, or were past victims of violent crimes when compared to those who were not in the crude analysis only. Health insurance coverage status generally did not significantly influence young adult's psychological well-being in the study.

Conclusions: The associations between mental health status and health insurance coverage status may have been strongly influenced by socio-demographic characteristics. Young adults, who reported poorer social health and poorer overall health when examining health insurance coverage status, were more likely to report poorer mental health status. It is important to understand ones mental, social, and physical health, in order to truly detail one's comprehensive health. Integration of mental health screening, screening for social health and the implementation of health care reform may help to improve mental health outcomes among young adults, especially the disadvantaged.