Unmet health care and health-related social needs of laundromat users

Objectives: To estimate the prevalence of unmet health care and health-related social needs (HRSNs) among laundromat users and examine differences by health insurance coverage.

Study design: Cross-sectional observational study.

Methods: We collected a survey from participants in a pilot intervention conducted in 14 Pennsylvania laundromats between September and December 2023. The measures included health insurance coverage, unmet health care needs, and unmet HRSNs. Descriptive analyses and linear probability regression models with laundromat fixed effects were used to estimate the overall prevalence of unmet needs and explore subgroup differences.

Results: Among the 1995 sample members, approximately half (52.9%) had Medicaid coverage, 21.7% had private coverage, 14.5% were uninsured, 5.4% had Medicare, and 5.5% were dually enrolled in Medicare and Medicaid. The prevalence of having any unmet HRSN was higher than having any unmet health care need (54.3% vs 12.3%). Across unmet need measures, Medicaid sample members had 1.5 to 5 times higher levels relative to the privately insured. Differences by insurance coverage remained in fixed-effects analyses that limited comparisons to laundromat users at the same location.

Conclusions: Laundromat-based outreach is likely most promising for Medicaid-serving stakeholders because Medicaid enrollees are disproportionately represented among laundromat users and have disproportionately high levels of unmet needs.