A study done in 1993 concluded that there was a 25% higher risk of death for uninsured adults compared to the privately insured. Applying the same methods used in the study, a study reported in the 2009 article titled “Health Insurance and Mortality in US Adults,” repeated the analysis with application of more recent data. In its findings, the study concluded that being uninsured associated with a higher risk of mortality. Further, the study found that the strength of the association of lack of health insurance and death was related to the association identified in a similar study done in 1980’s. That was despite the changes in demography and medical therapeutics of the uninsured over that period. (Woolhandler et al, 2009)
Although the survey sought to update the findings, it is noted that the researchers applied the same methodology that was applied in the 1993 study. In that respect, the study’s methodology could be outdated and should have been replaced with a more updated approach that could have considered more factors. Further, it is also notable that although the survey purports to have been a recent update of the earlier studies, the data used in the analysis and whose report was made in 2009 was collected in earlier years between the year 1984 and 1986. In that respect, the data does not reflect the real situation in the year 2009 as it referred to occurrences that had been overtaken by change in factors. In addition, the study’s assumption, that lack of insurance at the time of the study relate to deaths that occurred in a period of one year is flawed since the survey’s participants could have been insured during the period, but after the survey. In that respect, the relation of the annual deaths and lack of insurance at a certain point in that year have a negative effect on the study’s validity and reliability as it relates to variables that have different timeframes. (Cecere, 2009)
Further, the finding that the strength of the association between death and lack of insurance being relatively the same despite changes in demographics and medical therapeutics for the uninsured is an indication that the study had a weakness in accounting for other crucial factors. That association is in consideration that changes in demographic factors, as well as therapeutic care, should have a significant effect on death risk. The importance of such changes and factors appear on the report on chronic disease and new public health in 2010 as presented by public health center. In the report, it was indicated that chronic diseases are a great cause of death in both developing and developed countries and their effect on mortality rate is highly dependent on social status and much on factors like demographics as well as therapeutic care access. (Halpin, Morales-Suárez-Varela & Martin-Moreno, 2010)
Thus, social status and demographics can determine the proximity to the insurance services as well as the access to information about the private insurance. Good examples could be the better access of information about insurance and ease of being covered for the urban population and the youthful educated compared to the rural-based population as well as the aged and uneducated people. In that view, rather than a lack of insurance, those factors could be the direct cause of the high mortality rate for the rural-based, aged and uneducated people who are uninsured as their access to healthcare would be more difficult. In that respect, as indicated by the public health centre’s report on chronic diseases, the change in the two factors has significance in determining mortality hence they could have affected the identified rate. However, that seems to have not been well accounted for in the health insurance and mortality rate study. (Halpin et al, 2010)
In the article, there is the finding of a higher risk of death for the insured in comparison with the uninsured. Further, the risk has been found to be rising over time with the rate identified in the 2009’s study being relatively higher compared to that reported in the 1993’s study. However, there was a change in the mortality risk rate when the analysis adjusted some factors including the adults’ social and economic status, demographics and lifestyle resulted to a change in the risk rate. In that respect, the opinion by doctors that the cause for the higher risk is that the insured have better access to healthcare than the uninsured is not conclusive. Thus, the results could just be an indication of the difference in abilities between the socio-economic status of the insured and the uninsured. In that view, the access to healthcare by the insured is just an indication that those who can afford the private insurance have the capacity to take good health measures than the uninsured that would be assumed to also be less capable of affording the private health insurance. (Cecere, 2009)
Therefore, it would be incorrect to imply as the article concludes, that having a private health insurance is the part that reduces mortality rather than being a resulting part of the difference in individuals’ status. That could be a proper outcome given that the change in social, economic, lifestyle and health status to the negative in the study had an effect of increasing the mortality risk. In conclusion, it would be more proper to assume that insurance is not the determiner of the risk. That would mean the socioeconomic status that determines the access to private health insurance also determines the individuals’ health status. Rather than being determined by the coverage of private insurance, an individual’s health status depends on the access to proper nutrition and lifestyle as well as medical care. (HCS, 2002)
Cecere, D. “Study Finds 45,000 Annual Deaths Linked to Lack of Health Coverage.”
Harvard Gazette, 17 September 2009. Web. 24 April 2014.
Halpin H., Morales-Suárez-Varela M. & Martin-Moreno J. “Chronic disease prevention and
The New Public Health.” Public Health Reviews 32, (2010): 120-154.
Health Care Services (HCS). Care without Coverage: Too Little, Too Late.
Washington: The National Academies Press. 2002.
Woolhandler, S., Wilper, A., Lasser, K., McCormick, D., Bor, D. & Himmelstein, D. “Health
Insurance and Mortality in US Adults.” American Journal on Public Health 99.12, (2009)