Many uninsured adults do not receive needed medical care

Unmet health needs greatest among people uninsured more than 1 year

CHICAGO - American adults without health insurance are less likely than insured adults to receive preventive care or routine checkups, and more likely to report they could not see a physician because of cost, according to an article in the October 25 issue of The Journal of the American Medical Association, a theme issue on access to care.

John Z. Ayanian, M.D., M.P.P., of Brigham and Women's Hospital and the Harvard Medical School, Boston, and colleagues, compared survey data to estimate the unmet health needs of insured and uninsured U.S. adults. The study population was representative of more than 163 million U.S. adults aged 18 to 64 years residing in households during 1998 and approximately 161 million comparable adults in 1997. The study included 105,764 people aged 18 to 64 surveyed in 1997, and 117,364 surveyed in 1998, who were classified as long-term uninsured (without health insurance for a year or longer), short-term uninsured (without insurance for less than a year), or insured. Data came from the Behavioral Risk Factor Surveillance System (BRFSS), a federally funded survey designed by the Centers for Disease Control and Prevention (CDC) in collaboration with state health departments. Since 1994, all 50 states and the District of Columbia have administered the BRFSS survey and submitted data to the CDC.

According to background information cited in the study, approximately 33 million U.S. adults aged 18 to 64 were without health insurance in 1998. Prior studies have documented that lacking health insurance is associated with important clinical consequences. Uninsured adults are more likely than insured adults to report poor health status, delay seeking medical care, and forgo necessary care for potentially serious symptoms. Uninsured adults receive fewer screening services for cancer and cardiovascular risk factors, present with later-stage diagn

Contact: John Lacey
Center for the Advancement of Health

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