Health insurance and cardiovascular disease risk factors.
BACKGROUND
Compared with those with health insurance, the uninsured receive less care for chronic conditions, such as hypertension and diabetes, and experience higher mortality.


METHODS
We investigated the relations of health insurance status to the prevalence, treatment, and control of major cardiovascular disease risk factors-hypertension and elevated low-density lipoprotein (LDL) cholesterol-among Framingham Heart Study (FHS) participants in gender-specific, age-adjusted analyses. Participants who attended the seventh Offspring cohort examination cycle (1998-2001) or the first Third Generation cohort examination cycle (2002-2005) were studied.


RESULTS
Among 6098 participants, 3.8% were uninsured at the time of the FHS clinic examination and ages ranged from 19 to 64 years. The prevalence of hypertension and elevated LDL cholesterol was similar for the insured and uninsured; however, the proportion of those who obtained treatment and achieved control of these risk factors was lower among the uninsured. Uninsured men and women were less likely to be treated for hypertension with odds ratios for treatment of 0.19 (95% confidence interval [CI], 0.07-0.56) for men and 0.31 (95% CI, 0.12-0.79) for women. Among men, the uninsured were less likely to receive treatment or achieve control of elevated LDL cholesterol than the insured, with odds ratios of 0.12 (95% CI, 0.04-0.38) for treatment and 0.17 (95% CI, 0.05-0.56) for control.


CONCLUSIONS
The treatment and control of hypertension and hypercholesterolemia are lower among uninsured adults. Increasing the proportion of insured individuals may be a means to improve the treatment and control of cardiovascular disease risk factors and to reduce health disparities.
Brooks
Erica L
EL
The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass 01702-5803, USA.
Preis
Sarah Rosner
SR
Hwang
Shih-Jen
SJ
Murabito
Joanne M
JM
Benjamin
Emelia J
EJ
Kelly-Hayes
Margaret
M
Sorlie
Paul
P
Levy
Daniel
D
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008078:Cholesterol, LDL; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D006937:Hypercholesterolemia / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D006973:Hypertension / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D008078:Cholesterol, LDL