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Medicaid Enrollment by Municipality

August 29, 2018 Data Viz

By Julia Vieira, Research Intern, and Phil Sletten, Policy Analyst

There are significant disparities in the distribution of the New Hampshire population and median population ages between the southeastern region and more rural regions of the state, as municipalities located closer to metropolitan Boston typically have a lower median age than those in rural northern and western areas of the state. Aging demographics may prompt concerns regarding population health and health care costs, and differing income levels between different areas of the state also reflect differing service needs.

Using the January 2017 month-end count of Medicaid enrollment by municipality provided by the New Hampshire Department of Health and Human Services, the map below on the left shows the total number of residents enrolled in Medicaid by municipality. Medicaid generally seeks to provide health coverage for low-income people, with particular aspects of Medicaid focused on certain populations, including children, the elderly, and those with disabilities. The larger the number of residents enrolled in Medicaid, the darker the shade of purple. The municipalities with the largest total number of enrollees also tend to have the largest total populations, such as Manchester, Nashua, and Concord, followed by other municipalities with many residents overall but also relatively older or lower-income populations, such as Berlin, Conway, Laconia, and Rochester.

The share of the total population in each municipality that is enrolled in Medicaid provides a different indicator of the potential local needs for providing services to residents with low incomes, including certain older adults and residents with disabilities. Using the total number of enrollees in Medicaid by municipality and the 2010 Census count by municipality, the second map below shows Medicaid enrollees as a percentage of the total population. The larger the number of residents enrolled in Medicaid as a percentage of the total population of the municipality, the darker the shade of purple. Although populations have likely changed to some degree between the 2010 Census count and January 2017, the 2010 Census provides the best concrete number available for municipal populations, particularly for smaller municipalities, that does not introduce the potential error associated with small sample sizes in survey data.

The southeastern region of the state, with the exceptions of Manchester and several other smaller municipalities, appears to have smaller shares of the population enrolled in Medicaid, whereas the southwestern and, especially, the northern parts of the state have larger shares of residents enrolled.

Although Medicaid coverage is primarily paid through state and federal government dollars, certain long-term supports and services, particularly nursing home care, are paid in part by counties. Counties primarily raise tax revenue through property taxes. Differences in median ages, property values, and incomes across the state suggest that counties in the northern part of the state have less fiscal capacity but may face comparatively larger responsibilities in caring for residents.

For more on other metrics of economic activity and fiscal capacity in New Hampshire communities, see NHFPI’s Issue Brief Measuring New Hampshire’s Municipalities: Economic Disparities and Fiscal Capacities.

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New Data Show Food Insecurity Levels Declining Prior to the COVID-19 Crisis

10 Sep 2020

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According to data released on September 9 by the United States Department of Agriculture, food insecurity levels in New Hampshire continued to decline during 2019, prior to the onset of the ongoing COVID-19 crisis. The report outlines the trends of reduced food insecurity in the nation and in New Hampshire, declining from the higher levels resulting from the Great Recession of 2007 to 2009. The overall improvements to the state economy through 2019, along with the effectiveness of key nutritional aid programs, did contribute to lower levels of food insecurity, although the benefits of the economic recovery did not reach all Granite Staters in an equal or timely manner. Although food insecurity levels declined through the years preceding 2020, the current crisis facing Granite Staters is not reflected in these 2019 data. The recent economic pressures on many individuals and families with lower incomes in New Hampshire have been severe, and current levels of food insecurity are very likely to be substantially higher.