Every year, nearly 45,000 deaths are associated with lack of health insurance according to a study published online this week in the American Journal of Public Health. This estimate is around 2.5 times higher than an estimate from research conducted by the Institute of Medicine (IOM) in 2002.
According to an announcement about the study, deaths associated with lack of health insurance now exceed those caused by many common killers, such as kidney disease.
Researchers based at Harvard University found that uninsured, working-age Americans have a 40% higher risk of death than their privately insured counterparts, compared with a 25% excess death rate in 1993.
"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," said lead author Andrew Wilper, MD, MPH, who now teaches at the University of Washington Medical School.
The study analyzed data from national surveys carried out by the Centers for Disease Control and Prevention and assessed death rates after taking education, income, and many other factors including smoking, drinking, and obesity into account. The researchers concluded that lack of health insurance causes 44,789 excess deaths annually.
"Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives," said co-author Steffie Woolhandler, MD, MPH of Harvard.
The study’s announcement stated that previous estimates from the IOM and others put the excessive death rate near a much lower 18,000. 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.