Uninsured More Likely to Die, Study Finds

Sept. 18, 2009 — -- WASHINGTON — People without health insurance are 40 percent more likely to die than those with private insurance, according to a new study whose authors say the finding underscores the need to expand coverage to the 46 million who lack it.

According to the report, published today in the Journal of Public Health, lack of health insurance was a factor in the death of as many as 45,000 people in 2005.

Researchers lead by Dr. Andrew Wilper, of the Cambridge Health Alliance, an affiliate of Harvard Medical School, conducted a survival analysis of data from 9,000 adults under the age of 64 who were enrolled in the Third National Health and Nutrition Examination Survey (NHANES III).

Participants in the survey, which ran from 1986 through 1994, were asked questions about insurance, health status, income, and education, among other things, and were examined by a physician.

Among the 9,000 participants, about 16 percent were uninsured. People who were young, minorities, smokers, and had less education and income were more likely to be uninsured (P=0.01 for all comparisons).

For the current study, researchers looked at the number of people enrolled in NHANES III who had died by 2000 and determined about 3 percent of the participants were dead.

After adjusting for factors such as obesity, exercise habits, alcohol use, and smoking status, researchers determined those without insurance were 40 percent more likely to die than those with a private insurance plan.

Researchers excluded those on Medicare or Medicaid from their analyses.

Among the other factors that increased the risk of death were clinically-verified poor health (222 percent), smoking (102 percent), being a former smoker (42 percent), and being a male (40 percent).

So, while other factors clearly make a person more likely to die, the new finding suggests that being uninsured is more hazardous to the health than previously thought.

In fact, the risk factor is 2.5 times higher than a 2002 estimate from the Institute of Medicine (IOM), which that suggested about 18,000 people between the ages of 25 and 64 die per year because of lack of health insurance.