title: Private health insurance coverage and disability among older Americans.
abstract: OBJECTIVE
  This study examines the relationship between the lack of private supplemental health insurance coverage and the development of disability among adults aged 65 and older.
  
  
  METHODS
  Data are from the baseline and six follow-up waves of the Duke Established Populations for Epidemiologic Studies of the Elderly survey (N = 4,000). Discrete-time hazard models were used to estimate the impact of insurance coverage and other risk factors on the incidence of disability among those unimpaired at baseline.
  
  
  RESULTS
  Controlling for education, income, and other potential confounders, the odds of developing disability were 35-49% higher among those without private coverage. Insurance coverage also statistically explained part of the increased risk of disability among low-income persons.
  
  
  CONCLUSIONS
  The results indicate that changes in health insurance coverage as well as in individual behaviors may be needed to reduce disability generally and disability among the socioeconomically disadvantaged, in particular.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, USA. lrl@geri.duke.edu
authors.forename: L R
authors.initials: LR
authors.lastname: Landerman
authors.forename: G G
authors.initials: GG
authors.lastname: Fillenbaum
authors.forename: C F
authors.initials: CF
authors.lastname: Pieper
authors.forename: G L
authors.initials: GL
authors.lastname: Maddox
authors.forename: D T
authors.initials: DT
authors.lastname: Gold
authors.forename: J M
authors.initials: JM
authors.lastname: Guralnik
mesh_terms: D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007182:Income; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D014481:United States