Study: Some 45,000 Annual Deaths Linked to Lack of Health Insurance

For individuals without health insurance (estimated 47 million Americans), a recent study offers some sobering news.

Harvard-based researchers report in their study that about 45,000 annual deaths are linked to a lack of health insurance. That number is approximately two and a half times greater than an estimate from the Institute of Medicine (IOM) in 2002.

The new study, "Health Insurance and Mortality in U.S. Adults,' discovered that uninsured; working-age Americans have a 40 percent greater risk of dying than their privately insured counterparts, an increase from a 25 percent excess death rate reported in 1993.

According to lead author Dr. Andrew Wilper, who was employed at Harvard Medical School when the study was done and who now teaches at the University of Washington Medical School, "The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. 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.'

The study, which went over data from national surveys orchestrated by the Centers for Disease Control and Prevention (CDC), analyzed death rates once it took education, income and a number of other factors including smoking, drinking and obesity into account. It believes not having health insurance results in 44,789 excess deaths each year.

Deaths linked to the lack of health insurance now top those caused by a number of common killers like kidney disease.

Decreasing Medical Safety Net Leading to More Deaths

A gain in the number of uninsured and a decreasing medical safety net for the disadvantaged likely explain the substantial jump in the number of deaths associated with lack of insurance. Putting it simply, the uninsured are more apt to go without needed care.

Another factor contributing to the increasing gap in the risk of death between those who have health insurance and those who don't is the better quality of care for those who can get it.

The research, carried out at the Cambridge Health Alliance and Harvard Medical School, looked at U.S. adults under age 65 who took part in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents initially answered detailed questions regarding their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.

The study discovered a 40 percent greater risk of death among the uninsured. As expected, death rates were also more for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), individuals who reported that their health was fair or poor (126 percent increase), and those that examining physicians indicated were in fair or poor health (222 percent increase).

Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, added, "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate — now one dies every 12 minutes.'

The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.