A National Study of Chronic Disease Prevalence and Access to Care in Uninsured U.S. Adults

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dc.contributor.authorWilper, Andrew P.
dc.contributor.authorWoolhandler, Steffie
dc.contributor.authorLasser, Karen E.
dc.contributor.authorMcCormick, Danny
dc.contributor.authorBor, David H.
dc.contributor.authorHimmelstein, David U.
dc.date.accessioned2019-08-14T15:01:27Z
dc.date.available2019-08-14T15:01:27Z
dc.date.issued2008
dc.description.abstractBackground: No recent national studies have assessed chronic illness prevalence or access to care among persons without insurance in the United States. Objective: To compare reports of chronic conditions and access to care among U.S. adults, by self-reported insurance status. Design: Population-based survey. Setting: National Health and Nutritional Examination Survey (1999–2004). Participants: 12 486 patients age 18 to 64 years. Measurements: Estimates of national rates of cardiovascular disease, hypertension, diabetes, hypercholesterolemia, active asthma or chronic obstructive pulmonary disease, previous cancer, and measures of access to care. Results: On the basis of National Health and Nutrition Examination Survey (1999–2004) responses, an estimated 11.4 million (95% CI, 9.8 million to 13.0 million) working-age Americans with chronic conditions were uninsured, including 16.1% (CI, 12.6% to 19.6%) of the 7.8 million with cardiovascular disease, 15.5% (CI, 13.4% to 17.6%) of the 38.2 million with hypertension, and 16.6% (CI, 13.2% to 20.0%) of the 8.5 million with diabetes. After the authors controlled for age, sex, and race or ethnicity, chronically ill patients without insurance were less likely than those with coverage to visit a health professional (6.2% vs. 22.6%) and have a standard site for care (6.2% vs. 26.1%) and more likely to identify an emergency department as their standard site for care (7.1% vs. 1.1%) (P 0.001 for all comparisons). Limitation: The study was cross-sectional and used self-reported insurance and disease status. Conclusion: Millions of U.S. working-age adults with chronic conditions do not have insurance and have poorer access to medical care than their insured counterparts.
dc.description.urihttp://www.annals.org/content/149/3/170.abstract
dc.identifierhttps://doi.org/10.13016/2waq-uidf
dc.identifier.citationWilper, Andrew P. and Woolhandler, Steffie and Lasser, Karen E. and McCormick, Danny and Bor, David H. and Himmelstein, David U. (2008) A National Study of Chronic Disease Prevalence and Access to Care in Uninsured U.S. Adults. Annals of Internal Medicine, 149 (3). pp. 170-176.
dc.identifier.otherEprint ID 1048
dc.identifier.urihttp://hdl.handle.net/1903/22998
dc.subjectResearch
dc.subjectChronic Illness & Diseases
dc.subjectHealth
dc.subjectstudies
dc.subjectPublic Health
dc.subjectAccess To Healthcare
dc.subjectHealth Equity
dc.subjectchronic illness prevalence
dc.subjectaccess to care
dc.subjectinsurance
dc.subjectchronic conditions
dc.subjectinsurance status
dc.titleA National Study of Chronic Disease Prevalence and Access to Care in Uninsured U.S. Adults
dc.typeArticle

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