Medicare enrollees also on Medicaid and Material security score
Where Medicare enrollees also on Medicaid is higher, Material security score tends to be lower. The link is moderate: -0.47 across 3,082 counties, on a scale from −1 (opposite) to +1 (in step). That figure compares places with the same population density, income and education, so those differences can't explain it. It holds inside states too. Measured separately within each of 40 states, the middle value of the link is -0.70.
Holds after adjusting
Every place, plotted
One dot for each place reporting both measures. Hover over or tap a dot to see its name and values. The thin line is the straight line that best fits the dots. The bold line, shown for counties, is the link after adjusting for density, income and education. A dot far from the lines is a place that does not follow the pattern.
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What each measure is
Medicare enrollees also on Medicaid
The percentage of people in traditional Medicare who could also get Medicaid for at least one month of the year. Medicaid is the health program for people with low incomes, so this picks out older and disabled people who are also poor. People on both are often called dual eligible.
CMS Medicare Geographic Variation Public Use File · CMS Medicare Geographic Variation PUF, national/state/county, all ages, BENE_DUAL_PCT
Material security score
Poverty, child poverty, income inequality, and four basic-needs measures from CDC PLACES: food, housing, utilities and transport. It is flipped so higher means less hardship, which is why it is named for security, not for what it counts.
PlaceStats composite score · derived from 9 measures (ACS, BRFSS, CDC, SAIPE)
Highest and lowest
Where each measure is highest and lowest among the places reporting both (2023), with the other measure beside it. This is shown for every size of place where both are published. Metro-area values are added up from their counties. A measure that cannot be added up across counties, such as a middle value (median), has no metro figure. Counts are shown per 1,000 residents, since raw totals would only list the largest places. Cities and towns and ZIP codes are shown where the Census survey or the CDC publishes them; most other sources stop at the county. They are shown for places of 5,000 residents or more, and only where the survey’s margin of error is small enough for the figure to be usable. The CDC publishes its health estimates for cities in a version adjusted for age, so places with older or younger people can be compared fairly, but not for ZIP codes.
Counties
By Medicare enrollees also on Medicaid
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Highest | ||
| Kusilvak Census Area, AK | 70.2 | -2.62 |
| Bethel Census Area, AK | 63.4 | -1.97 |
| Starr County, TX | 58 | -2.04 |
| Imperial County, CA | 57.6 | -0.89 |
| Northwest Arctic Borough, AK | 57.4 | -0.93 |
| Lowest | ||
| Beaufort County, SC | 2.05 | 0.446 |
| Summit County, UT | 2.43 | 1.1 |
| Sumter County, FL | 2.76 | 0.505 |
| Teton County, WY | 2.77 | 0.589 |
| James City County, VA | 2.87 | 1.19 |
By material security score
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Highest | ||
| Morgan County, UT | 3.32 | 1.83 |
| Los Alamos County, NM | 3.73 | 1.82 |
| Douglas County, CO | 5.37 | 1.69 |
| Loudoun County, VA | 7.1 | 1.64 |
| Forsyth County, GA | 5.03 | 1.56 |
| Lowest | ||
| East Carroll Parish, LA | 33.1 | -3.95 |
| Holmes County, MS | 36.8 | -3.64 |
| Ziebach County, SD | 31.4 | -3.46 |
| Martin County, KY | 29.5 | -3.33 |
| Sioux County, ND | 37.9 | -3.24 |
States
By Medicare enrollees also on Medicaid
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Highest | ||
| District of Columbia | 37.1 | -0.281 |
| California | 30.6 | 0.0683 |
| Maine | 26.6 | 0.594 |
| Connecticut | 24.9 | 0.378 |
| Massachusetts | 23.2 | 0.747 |
| Lowest | ||
| South Carolina | 6.69 | -0.529 |
| Arizona | 8.37 | -0.0792 |
| Virginia | 8.72 | 0.601 |
| Utah | 8.76 | 0.93 |
| Hawaii | 9.47 | 1.14 |
By material security score
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Highest | ||
| New Hampshire | 12.3 | 1.36 |
| Hawaii | 9.47 | 1.14 |
| Vermont | 21.9 | 1.07 |
| Minnesota | 18 | 0.969 |
| Utah | 8.76 | 0.93 |
| Lowest | ||
| Mississippi | 17.8 | -1.25 |
| Texas | 10.8 | -1.03 |
| Louisiana | 19.9 | -1.02 |
| Arkansas | 15.6 | -0.851 |
| Alabama | 13.8 | -0.811 |
Metro areas
By Medicare enrollees also on Medicaid
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Highest | ||
| El Centro, CA | 57.6 | -1.32 |
| Gallup, NM | 39.4 | -4.3 |
| Merced, CA | 38.7 | -1.11 |
| Bakersfield-Delano, CA | 38.4 | -1.15 |
| Los Angeles-Long Beach-Anaheim, CA | 38.1 | 0.178 |
| Lowest | ||
| Hilton Head Island-Bluffton-Port Royal, SC | 2.36 | 0.517 |
| Heber, UT | 2.94 | 1.79 |
| Los Alamos, NM | 3.73 | 2.07 |
| Jackson, WY-ID | 4.27 | 1.38 |
| Murrells Inlet, SC | 4.7 | -0.0584 |
By material security score
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Highest | ||
| Los Alamos, NM | 3.73 | 2.07 |
| Heber, UT | 2.94 | 1.79 |
| Nantucket, MA | 10.1 | 1.7 |
| Appleton, WI | 14.6 | 1.55 |
| Manchester-Nashua, NH | 13.3 | 1.44 |
| Lowest | ||
| Gallup, NM | 39.4 | -4.3 |
| Clarksdale, MS | 32.8 | -3.97 |
| Cleveland, MS | 27.5 | -3.8 |
| Greenville, MS | 27.6 | -3.64 |
| Selma, AL | 31.7 | -3.37 |
Counties furthest from the pattern
Compared with the straight line that best fits all 3,095 counties: the five with far more material security score than their Medicare enrollees also on Medicaid would suggest, and the five with far less.
| Medicare enrollees also on Medicaid | Material security score | |
|---|---|---|
| Above the line | ||
| San Francisco County, CA | 50.5 | 0.442 |
| Franklin County, KY | 50.3 | 0.292 |
| Wayne County, NY | 43.9 | 0.65 |
| Aleutians West Census Area, AK | 35.2 | 1.14 |
| Alameda County, CA | 39.5 | 0.642 |
| Below the line | ||
| Issaquena County, MS | 12.6 | -2.72 |
| East Carroll Parish, LA | 33.1 | -3.95 |
| Allendale County, SC | 12.8 | -2.45 |
| Ziebach County, SD | 31.4 | -3.46 |
| Martin County, KY | 29.5 | -3.33 |
Two series, one county
Both measures over time for a county you pick. The two charts are stacked, so they share only the years along the bottom. You can pick from the thirty largest counties reporting both. This panel covers 2010–2024, and a measure published only once shows as a single dot.
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Every version of the link
Each row measures the same link, from −1 to +1, in a different way. If the rows mostly agree, the link does not depend on one choice of method.
| Before adjusting for anything | -0.569 | 3,082 counties reporting both |
| After adjusting for density, income and education | -0.466 | the part of the link that is not just how urban, rich and educated a place is |
| Also adjusting for population size | -0.459 | size taken out as well as density |
| Also comparing only within each state | -0.519 | each county is compared only with others in its own state, so this is no longer a comparison between states |
| Also holding winter sunshine equal | -0.550 | compares counties that get the same sunlight in winter as well. If this is much weaker, part of the link is a difference between sunny and grey regions (more) |
| Giving bigger counties more weight | -0.488 | the adjusted link for the average resident rather than the average county. With this weighting, the data counts for about 287 equally weighted counties |
| Middle value inside single states | -0.705 | the link worked out inside each of 40 states with at least 20 counties reporting |
| Using ranks, after adjusting | -0.302 | uses each county’s rank, not its value, so a few extreme counties cannot create the link |
How much to believe it
Could it be chance?
The p-value is the chance of seeing a link this strong if there were really none. A value of 0.05 or less means the link is unlikely to be chance. Very small values are written in short form: 3.1e-16 means 0.00000000000000031, and the bigger the number after “e-”, the smaller the value. Treating every county as a separate case gives p = 9.1e-166. But counties in the same state tend to resemble each other, so the better figure allows for that: p = 8.0e-10. The site tested 32,131 pairs, and testing so many turns up some flukes. The q-value allows for that too. For this pair it is 1.3e-164.
Do nearby places look alike?
Moran’s I measures how much nearby places look alike: 0 means no map pattern, and higher means neighbours are more similar. For the part of each county that the adjustment leaves unexplained, it is +0.54 (p = 0.001). That unexplained part still clusters on the map. So some regional factor shared by both measures is not accounted for.
Did they change together?
Not measurable: at least one of these is published for too few of the years a change needs (2014–2019 or 2019–2023), or for too few counties in both.
Related pairs
- Self-care disability and Material security score — -0.88
- Stroke and Material security score — -0.86
- Vision disability and Material security score — -0.83
- Received food stamps and Material security score — -0.82
- Fair or poor self-rated health and Material security score — -0.80
- Independent-living disability and Material security score — -0.80
- Mobility disability and Material security score — -0.80
- Diagnosed diabetes and Material security score — -0.79
Association only. Nothing here shows that either measure changes the other. This describes counties, not the people in them. Two measures going together across places does not mean the same people have both. How the US county data works · Explore Medicare enrollees also on Medicaid and Material security score