Study: Noninsurance means an extra 45,000 deaths annually

A study in today's online edition of the American Journal of Public Health has found that nearly 45,000 deaths annually are associated with a lack of health insurance.

The study was authored by a team of Harvard University researchers led by Andrew Wilper, MD, who now teaches at the University of Washington Medical School in Seattle. The authors found that uninsured, working-age Americans have a 40 percent higher risk of death than those Americans who are privately insured. This figure, according to the authors, is up from a 25 percent excess death rate found in 1993.

The authors collected and analyzed data from national surveys carried out by the Centers for Disease Control and Prevention and assessed death rates after taking factors such as education, income, smoking, drinking and obesity into account. The estimate of 45,000 excess deaths was substantially higher than that of the Institute of Medicine, which in 2002 determined that 18,000 excess deaths could be annually attributed to a lack of health insurance.

A number of reasons account for the expanding number of deaths associated with noninsurance, the authors said, including the increasing number of people who are uninsured, as well as a shrinking safety net for the disadvantaged population. The authors suggest another factor in the risk-of-death gap between the noninsured and the insured is the improved quality of care for those who can get it.

Specific categories of the insured population are particularly at risk, according to the study. Current or former smokers have a 102 percent and 42 percent increased risk of death, while  people who said that their health was fair or poor had 126 percent increase and those that examining physicians said were in fair or poor health had a 222 percent increase.

“The uninsured have a higher risk of death when compared with the privately insured, even after taking into account socioeconomics, health behaviors and baseline health,” said Wilper. “We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease--but only if patients can get into our offices and afford their medications."
Michael Bassett,

Contributor

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