Health Insurance Coverage and the Risk of Decline in Overall Health and Death Among the Near Elderly, 1992-2002

By | May 11, 2006

In a study published in the journal Medical Care in March, Drs. David Baker and Joseph Sudano and their colleagues found that uninsured older Americans experienced more rapid declines their health compared to insured Americans of the same age. The uninsured individuals usually enrolled in public insurance programs like Medicare later, after their health was already poorer. The later enrollment resulted in higher health costs than if they had continuous health insurance. Individuals who started out uninsured also had a 35% higher mortality rate.

This study analyzed data from the Health and Retirement Survey. The Health Retirement Survey enrolled about 10,000 adults with an average age of 56 at the start of the study. Study participants were surveyed every 2 years since 1992. Individuals with no insurance at each 2 year survey had a 43% higher risk of a serious decline in health compared to insured individuals. Those uninsured had 35% higher mortality rates over the 10 years of the survey compared to insured individuals.

The authors findings showed that many of the uninsured transition to public insurance prior to their death and the situation appears to be one of ÒPay me now or pay me laterÓ Their study supports the work by researchers Hadley and Waidmann who estimated that Medicare and Medicaid would spend approximately $19 billion less on care for newly enrolled beneficiaries in the first 5 years of coverage if they were insured for the 8 years prior to entering Medicare. Their results suggest that expanding healthcare coverage to those ages 50-65 would lead to improved health in those individuals and lower costs to Medicare. (posted 5/2006) Joseph Sudano, Medical Care

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About Joseph J. Sudano

I have been trained as a medical sociologist and health services researcher and am currently a faculty member in the Population Health Unit in the Center for Health Care Research and Policy, Case Western Reserve University at The MetroHealth System and Assistant Professor in the Department of Medicine, Case Western Reserve University. I am also the Director of Education in the Center for Reducing Health Disparities at Case Western Reserve University. My current research interests include: disparities in health care access, utilization and health outcomes concentrating on minorities and other vulnerable populations; social determinants of health including community/contextual characteristics (e.g., residential segregation, SES/poverty, job opportunities); measurement equivalence, validity and item-response theory in cross-cultural health status measurement; culturally-specific health beliefs and behaviors; general cognitive ability, personality, and education in relationship to health status and health behaviors; structural equation modeling/path analysis in health outcomes research; health related survey data collection and analysis; international health services research.