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On the Care of the Poor and the Uninsured

Boris M. Astrachan, MD; Donald J. Scherl, MD
Arch Gen Psychiatry. 1991;48(5):481. doi:10.1001/archpsyc.1991.01810290093017.
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Access of the poor to mental health services is varied and in many sections of the nation reflects Medicaid payment policies and the availability of state- and/or county-supported programs. Norquist and Wells1 demonstrate in this issue of the Archives that in Los Angeles (Calif), a relatively resource-rich community with fairly extensive state-supported services, those without health insurance may well have less adequate access to mental health care than do poor residents who are eligible for Medicaid, yet the Medicaid-eligible residents and uninsured residents had similar prevalences of serious psychiatric disorders.

See also pp 470 and 475.  The poor tend to be sicker. As Bruce et al2 demonstrate, after comparing the low-income population, which is defined in much more precise terms than has been the case in the earlier literature, with the general population, previously "healthy" poor people are almost twice as likely to develop mental illnesses over


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