NEW YORK (Reuters) -- One out of every five Americans between the ages of 18 and 64 does not have health insurance or has inadequate insurance coverage, a new report suggests. What's more, most of those lacking in adequate health coverage are employed, according to state-by-state data released by the Centers for Disease Control and Prevention (CDC).
Overall, Hawaii residents are most likely to have adequate health insurance, whereas residents in the South, Southwest and West are less likely to be adequately covered.
"In the United States, cost of healthcare services is a barrier to accessibility of healthcare, and persons often do not seek medical care because of concerns about cost, regardless of whether they have health insurance," the authors wrote.
Data from the Behavioral Risk Factor Surveillance System (BRFSS) was used to determine the insurance status of people in all 50 states between the ages of 18 and 64. A total of 90,691 people responded to the 1995 telephone survey.
The survey found that 6.8% to 24.6% of people were uninsured, and 4.3% to 9.0% were underinsured. The underinsured were considered to be those people who said they had insurance, but also said they did not go to see a doctor because they were concerned about cost.
"Among persons employed for wages, estimates of either underinsured or uninsured persons ranged from 7.9% (Hawaii) to 28% (Louisiana)," according to the report. Those who were unemployed were less likely to have insurance. In that case, 24% to 60% lacked insurance and 1.2% to 21% were underinsured.
And the CDC notes that the survey may underestimate lack of insurance problems across the US because it did not reach people without a telephone, who may be even more likely to lack insurance because of a lower socioeconomic status.
"Previous reports have indicated a decline in the proportion of persons in the United States with health insurance, including a decline among employed persons," the authors wrote. The analysis "also indicates that most persons who were uninsured or underinsured were employed, and approximately one fifth of employed adults were either uninsured or underinsured, possibly reflecting the inadequacy of employer-based healthcare coverage."
SOURCE: Morbidity and Mortality Weekly Report (1998;47:51-55)
