Associations of Health Insurance, Household Income, and Cost-Related Healthcare Barriers With Routine Medical Checkup Utilization Among U.S. Adults: Evidence From the 2024 BRFSS

Abstract Objective To examine associations of health insurance status, household income, and cost-related healthcare barriers with receipt of a routine medical checkup among U.S. adults. Methods This cross-sectional study analyzed 2024 Behavioral Risk Factor Surveillance System data. Survey-weighted descriptive estimates and multivariable logistic regression incorporated sampling weights, strata, and primary sampling units. The outcome was a routine medical checkup within the previous 12 months. Results Among 321,592 complete cases, 78.0% of U.S. adults reported a recent routine checkup. Cost-related barriers (adjusted odds ratio [AOR], 0.56; 95% confidence interval [CI], 0.54-0.57) and uninsurance (AOR, 0.28; 95% CI, 0.27-0.29) were associated with lower checkup utilization. Lower household-income groups generally had lower adjusted odds than adults with incomes of $200,000 or more. Conclusions Insurance, income, and reported cost barriers were independently associated with routine checkup utilization. Findings are descriptive and do not establish causal effects.