Unhealthy and uninsured: exploring racial differences in health and health insurance coverage using a life table approach

Demography. 2010 Nov;47(4):1035-51. doi: 10.1007/BF03213738.

Abstract

Millions of people in the United States do not have health insurance, and wide racial and ethnic disparities exist in coverage. Current research provides a limited description of this problem, focusing on the number or proportion of individuals without insurance at a single time point or for a short period. Moreover, the literature provides no sense of the joint risk of being uninsured and in need of medical care. In this article, we use a life table approach to calculate health- and insurance-specific life expectancies for whites and blacks, thereby providing estimates of the duration of exposure to different insurance and health states over a typical lifetime. We find that, on average, Americans can expect to spend well over a decade without health insurance during a typical lifetime and that 40% of these years are spent in less-healthy categories. Findings also reveal a significant racial gap: despite their shorter overall life expectancy, blacks have a longer uninsured life expectancy than whites, and this racial gap consists entirely of less-healthy years. Racial disparities in insurance coverage are thus likely more severe than indicated by previous research.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data*
  • Age Distribution
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Health Status
  • Health Status Disparities*
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Life Tables*
  • Male
  • Medically Uninsured / ethnology*
  • Medically Uninsured / statistics & numerical data
  • Middle Aged
  • Socioeconomic Factors
  • United States
  • Young Adult