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Tracy James
IU Communications

Kristen Ditsch
IU Communications

Last modified: Friday, February 10, 2012

IU study shows stigma around free health care, but high satisfaction with services

Feb. 15, 2012

BLOOMINGTON, Ind. -- A new study by Indiana University sociologists found that a stigma exists against individuals seeking free health care services. Patients of a free health care clinic reported in a survey that many people would be embarrassed about admitting they sought services from such a clinic.

Elizabeth Thompson, Oren Pizmony-Levy and Kathleen Oberlin

Elizabeth Thompson, Oren Pizmony-Levy and Kathleen Oberlin

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"The societal stigma against publicly seeking free health services is an important factor in people's decision to seek available resources, like Volunteers in Medicine (VIM) of Monroe County," said researcher Oren Pizmony-Levy, a doctoral student in IU's Department of Sociology. "This inherent belief that seeking free services is bad means that programs like the VIM need to focus on addressing this issue with a public campaign."

VIM is a national program serving people whose income is 200 percent of the federal poverty line (roughly $44,700 for a family of four) and are without health insurance. The Monroe County chapter began in 2007, with the assistance of IU Health Bloomington Hospital. It now serves 60 percent of the eligible population, up from only 10 percent the first year, in Monroe and Owen counties. Clinic operators would like to serve even more, which is why they teamed up with IU for the study.

The survey, which included more than 700 patients of Volunteers in Medicine of Monroe County (Ind.), found high levels of satisfaction in services provided.

"The most encouraging result of this study is the high level of satisfaction that our patients express about their services received here," said Elizabeth Thompson, executive director of VIM of Monroe County.

The study also revealed an unexpected diverse demographic in the current population served by VIM, said Kathleen Oberlin, also a doctoral student in the Department of Sociology.

"With 55.9 percent of VIM patients being employed or currently working for pay and 46.5 percent having some form of higher education, whether it be some college course work or an advanced degree, we get a more precise understanding of the broad demographic base VIM serves, which flies in the face of commonly held assumptions," she said.

Pizmony-Levy said their ongoing research contributes to the national dialogue about affordable health care and also highlights concrete efforts to address the issue.

"While we are having political discourse about whether we should provide free health care services, people on the ground are taking action to provide free services," he said.

The full report is available online.

The survey represents 741 VIM patients who visited the clinic between December 2009 and February 2011. Major findings include:

  • The population using VIM services is diverse. The study showed that patients of the clinic were coming from diverse demographics and socio-economic backgrounds. "VIM serves individuals with higher education, individuals who currently are employed or have been employed in the past five years," Oberlin said. "This pattern suggests the health care crisis is far-reaching and severe."
  • The majority of patients are satisfied with the services received at VIM. Eight out of 10 respondents provided positive feedback regarding their experiences at the clinic. "We would like to reach more people through our patients. Most of our patients are referred by family and friends," said Thompson, who stresses that the positive feedback will hopefully translate into more talk about the services among family and friends.
  • Individuals rely on information from friends, family and the Internet. "The study shows that patients are actively seeking information about health care through different resources," Thompson said. The survey indicates that an overwhelming 65.6 percent of patients sought information in the past year; the most frequently listed resources were the Internet, medical professionals, family and friends. Thompson added that VIM would like to help patients get more engaged and help them in managing their health because of this overwhelming percentage of the population who want to take action and improve their health.
  • Embarrassment might prevent uninsured people from seeking free health services. While nearly all individuals (91 percent) say they are not embarrassed to use free health services, one out of three (29.1 percent) think others would be embarrassed to admit they sought free health services. Pizmony-Levy said this indicates patients assume there is a social stigma against seeking free health services, which might explain why uninsured people are still not using VIM services. Half of the survey respondents (50.4 percent) also reported that they know at least one person who is uninsured and eligible for services but not currently a VIM patient.

For more information, contact Tracy James at 812-855-0084 or, or Kristen Ditsch at 812-855-3911 or

About VIM

Volunteers in Medicine is a free medical clinic for adults without health insurance and living below 200 percent poverty. More than 75 clinics serve patients across the United States, since the program's creation in 1996 at a South Carolina clinic. The Monroe County VIM seeks to serve the more than 12,000 individuals in Monroe and Owen counties. VIM is operated by volunteers and through the support of IU Health Bloomington Hospital and the community, to provide primary and preventive services for more than 20,000 patient visits annually.