The high mortality of individuals without health insurance may be due to their inability to get appropriate care during lapses or gaps in insurance coverage, or perhaps to other socioeconomic factors including unemployment and a lack of education, the study found. Individuals without health insurance also may delay seeking medical care, increasing the chance that a health condition will worsen and become life-threatening.

Overall, the authors emphasized the importance of social factors when examining the risk of dying. When researchers address the subject, they tend to focus on behavioral factors like smoking, proper diet and exercise, Rogers said.

"All of those factors are important but money may make a bigger difference," he said. "For example, factors that indirectly encourage people to smoke include low education, low income and unemployment. So socioeconomic factors must be underscored as important factors that influence mortality."

The study also found that foreign-born individuals of most U.S. ethnic groups had lower risks of death in the follow-up period compared to U.S.-born individuals of the same ethnic groups. This suggests that the generally low mortality of the foreign-born populations helps to maintain the largely favorable health profile of several U.S. ethnic groups, particularly Hispanics and Asian Americans.

Though not often discussed in debates about immigration policy, such patterns suggest that continued streams of healthy and select immigrants may be important in maintaining a health profile for several U.S. ethnic groups.

"The force of death is not the same for everyone," the study concluded.

"The force of death in the contemporary United States is stronger for the poor, the less educated, the unemployed and the uninsured than for the rich, the highly educated and the insured; for males rather than for females; for those who rarely attend religious servi
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Contact: Richard Rogers
Richard.Rogers@colorado.edu
303-492-2147
University of Colorado at Boulder
21-Nov-1999