Who are the uninsured elderly in the United States?
Because of the Medicare program, a common assumption is made that virtually all older Americans have health insurance coverage. Data from the 2000 National Health Interview Survey were analyzed to estimate the number of people aged 65 and older without health insurance; their stated reasons for being uninsured; and the associations between lack of insurance and sociodemographic variables, health status, and access to and use of healthcare services. In 2000, there were approximately 350,000 older Americans with no health insurance. Those without insurance were more likely to be younger, Hispanic, nonwhite, unmarried (widowed, divorced, or never married), poor, and foreign-born. They were less likely to hold U.S. citizenship. Despite relatively high rates of chronic medical conditions, they were unlikely to receive outpatient or home healthcare services. The most common reason given for lack of insurance was its cost. This study reveals important gaps in the availability of health insurance for the elderly, gaps that are likely to affect an increasing number of older Americans in the coming decade.
Mold
James W
JW
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. jamesmold@ouhsc.edu
Fryer
George E
GE
Thomas
Cynthia H
CH
D000203:Activities of Daily Living; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002908:Chronic Disease / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D015577:Geriatric Assessment; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D017054:Insurance, Medigap / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008489:Medical Indigency / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data; D009017:Morbidity; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology