Intermittent lack of health insurance coverage and use of preventive services

Am J Public Health. 2003 Jan;93(1):130-7. doi: 10.2105/ajph.93.1.130.


Objectives: This study examined the association between intermittent lack of health insurance coverage and use of preventive health services.

Methods: Analyses focused on longitudinal data on insurance status and preventive service use among a national sample of US adults who participated in the Health and Retirement Study.

Results: Findings showed that, among individuals who obtain insurance coverage after histories of intermittent coverage, relatively long periods may be necessary to reestablish clinically appropriate care patterns. Increasing periods of noncoverage led to successively lower rates of use of most preventive services.

Conclusions: Intermittent lack of insurance coverage-even across a relatively long period-results in less use of preventive services. Studies that examine only current insurance status may underestimate the population at risk from being uninsured.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Episode of Care
  • Female
  • Health Behavior
  • Health Status
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Medically Uninsured / statistics & numerical data*
  • Middle Aged
  • Outcome Assessment, Health Care / economics*
  • Outcome Assessment, Health Care / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Preventive Health Services / economics
  • Preventive Health Services / statistics & numerical data*
  • Socioeconomic Factors
  • United States / epidemiology