Wilper, A., Woolhander, S., Lasser, K., McCormick, D., Borr, D., & Himmelstein, D. (2009). Health Insurance and Mortality in US Adults. American Journal of Public Health. 99(12), 2289-2295.
1. The United States is the only industrialized nation that does not provide health coverage to all of its citizens.
a. There are 46 million Americans that are without coverage.
b. Uninsurance remains a common and major problem in the US despite the many attempts to expand health care coverage.
2. Why is health insurance important?
a. Health insurance helps to aid individuals in gaining access to health care services
b. It helps to protect individuals against the high costs of illnesses and procedures
c. Individuals with health insurance have more services available to them
i. Compared to the uninsured, insured Americans are more likely to undergo screenings and care for long-term illnesses.
1. More likely to seek preventative care
a. If a co-pay is $5 you are more likely to go to the doctor than if you had to pay in full
b. Paying out of pocket is a disincentive to go to the doctor
ii. They are also less likely to suffer from undiagnosed conditions due to the access to recommended screenings.
3. Health coverage has a direct impact on your life.
a. In 1993, one study found that uninsured individuals were at a 25% higher risk of death than those individuals with insurance.
b. Since then, many other studies, including this one, have found an association between uninsurance and death.
c. In 2001 the Institute of Medicine (IOM), estimated that 18,314 Americans ages 25-64 die annually due to lack of heath insurance.
i. This is similar to the amount of deaths due to diabetes, stroke, or homicide in 2001 among the same age group.
1. To complete this study, a survival analysis was conducted which included an interview, physical examination, and laboratory testing.
2. Individuals ages 17-64 were analyzed to determine if uninsurance at the time of the study could predict death.
a. Individuals over 64 were excluded because they were eligible for Medicare.
b. Individuals covered under Medicaid and the Department of Veterans Affairs/Civilian Health and Medical Program of the Uniformed Services military insurance were also excluded from the study
3. Participants were asked questions about race, ethnicity, income, household size, education, employment, tobacco use, alcohol use, and leisure exercise.
a. Using the information from the surveys and tests a score model was developed to calculate the number of US adults who die annually due to the lack of health insurance.
1. 9,004 individuals contributed to the survey
a. Of those people, 16.2% of individuals were uninsured at the time of the interview
b. By the end of the follow-up in 2000, 351 individuals, 3.1% of the participants have died.
2. Uninsurance was associated with many factors including younger age, minority race/ethnicity, unemployment, smoking, exercise, self-rated health, regular...