By Doug Trapp
AMNews
Posted Oct. 2, 2009
The uninsured might be about 40% more likely to die than the privately insured, according to a study published online Sept. 17 in the American Journal of Public Health. In contrast, a 1993 Institute of Medicine study concluded that those without health coverage were 25% more likely to die.
Nearly 45,000 people in 2005 might have died, in part, because they had no health insurance. That was the conclusion of “Health Insurance and Mortality in U.S. Adults,” authored by Cambridge Health Alliance researchers (www.ajph.org/cgi/content/abstract/AJPH.2008.157685v1/).
“The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health,” said lead author Andrew Wilper, MD, MPH, an internist who teaches at the University of Washington School of Medicine.
The authors used medical records from the Center for Disease Control and Prevention’s Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994. They narrowed the sample and excluded those who were younger than 17 or older than 64, who had government health insurance, and who didn’t complete all the physical exams and background information for the CDC’s study. Then the authors matched names to the National Death Index, a compilation of state death records, and extrapolated the mortality rate for 2005 using U.S. Census Bureau records.
Sixteen percent of the 9,000-person sample, or about 1,400 people, were uninsured, according to the study. The uninsured also were much more likely to be young, unemployed and/or a member of a minority group. They also were more likely to smoke, to forgo exercise, and to have lower levels of education and income than were the rest of the sample, after controlling for health status and demographic background.
The study was limited in that the authors could not verify the self-reported insurance status of participants, nor measure the effect of gaining or losing coverage after the interview. But the authors excluded people who did not provide complete medical information. Those people were more likely to be uninsured than the rest of the sample, the researchers said.