Primary Care Medicine
Professor Nancy E. Reid, MHA, DHSc, PA-C
This manuscript examines the literature evidence that being uninsured is an independent risk factor for poor health in the US.
A literature search was conducted through PubMed and MedLine using the search terms: uninsured, underinsured, risk factor, poor health. The search results identified 245 articles. The search was repeated adding the search term: Medicaid. The search results reduced the number of articles to 55. These results were filtered to include articles published within the past 5 years and the yield was 30 articles. Five articles of pertinent original source material published greater than 5 years ago were retained. Articles not directly relevant to the US medical environment were excluded and the remaining 21 articles were included in this review.
The evidence reviewed here demonstrates a definitive association between being uninsured and poorer health outcomes. This review finds that being uninsured is an evidence-based risk factor for poorer health.
Without insurance, an individual is at risk for significantly fewer cancer screenings leading to more advanced disease and reduced survival rates with a cancer diagnosis. Changing from an uninsured status to an insured status has rapid, dramatic, and positive outcomes in application of screening tests and in self-appraisal of well-being. These positive changes are seen promptly with the ending of the uninsured status.
This review finds that being uninsured is an evidence-based risk factor for poorer health. Knowing this risk factor, providers and their professional associations have the societal responsibility to support amelioration of it. Supporting and facilitating universal healthcare – through a single source or through multiple sources – ends this risk factor in America.
Nantz C. Is the Absence of Health Insurance an Independent Risk Factor for Poor Health in The United States. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2019; 1(4).
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