Millions of Chronically Ill Working Americans Do Not Have Insurance

Mar 3, 2009 by

Millions of Chronically Ill Working Americans Do Not Have Insurance

Healthcare and medical costs in the United States are spiraling out of control. Yet, a study has found that millions of working Americans who suffer from chronic health conditions do not actually have insurance.

It’s hardly a healthy situation at all. Read on for more details.

Millions of Working Americans Have Chronic Diseases But Are Uninsured

by Reuben Chow

A study recently published in the Annals of Internal Medicine found that millions of working-age persons in the United States who suffer from chronic health conditions do not have insurance coverage and have poorer access to medical care as compared to their insured counterparts.

Details of Study

The study looked at data from the National Health and Nutritional Examination Survey (NHANES) (1999-2004) in the United States and took into account estimated rates of various illnesses, such as asthma, previous cancer, cardiovascular disease, diabetes, hypertension and obstructive lung disease, as well as measures of healthcare access. Those studied ranged from age 18 to 64.


Based on those statistics, the study team estimated that 11.4 million Americans of working age who suffered from chronic health conditions did not have insurance. This means that almost one in three adults of working age who did not have insurance coverage had been diagnosed with a chronic disease –- there were about 36 million uninsured Americans in 2004. And a number of these people may even have had multiple chronic illnesses.

This included about 16% of the 7.8 million who had cardiovascular disease, 15.5% of the 38.2 million with hypertension, and more than 16.5% of the 8.5 million who suffered from diabetes.

Further, when factors such as age, ethnicity and gender were controlled, persons who were chronically ill but not insured were more than three times more likely not to have consulted a health professional (22.6% against 6.2%) and more than four times more likely not to have had a standard site for medical care (26.1% against 6.2%) in the past 12 months, when compared to those with insurance coverage. On the other hand, they were much more likely (7.1% against 1.1%) to have reported using an emergency department as a standard site for medical care.

Given these numbers, it was also quite likely that a significant number of the uninsured actually did suffer from some kind of yet-to-be-diagnosed chronic condition.

Why did so many Americans of working-age not have insurance coverage?

The researchers put forth a few possible reasons for the high proportion of uninsured working-age Americans. These included the decreasing size of many American companies and employer-sponsored coverage being eroded by the decline in manufacturing jobs.

Increasing premiums might worsen the situation, as it would discourage companies from covering their employees, discourage participation by workers who were required to co-pay insurance premiums, as well as make insurance much more unaffordable for those who were self-employed, especially if they were already diagnosed with a chronic condition.

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