Dying Too Young for Lack of Coverage

Death is a certainty, but premature death stalks the uninsured. A state-by-state body count.

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If we want to measure how well our healthcare system is working, tracking premature death is arguably the ultimate yardstick. Now a new study spells out, state by state, how many people died in 2006 because they didn't have health insurance. In California, for instance, more than eight working-age people died each day because they lacked coverage, a total of 3,100 for the year. The death toll from lack of insurance was 390 in Arkansas. And so on.

The concept isn't new, but seeing the numbers spelled out for your own state literally brings it home. In 2002, the Institute of Medicine found that adults without insurance were 25 percent more likely to die before their time than those with private insurance. It estimated that 18,000 adults died in 2000 for this reason. The Urban Institute later updated that figure to 22,000 for 2006. Families USA, a nonprofit health advocacy group, has now broken down the figures for 25- to 64-year-olds in every state and the District of Columbia. The group's report, "Dying for Coverage," was released today.

"Health insurance really matters in how people make their healthcare decisions," says Ron Pollack, Families USA's executive director. "We know that people without insurance often forgo checkups, screenings, and other preventive care."

The connection between health insurance and premature death has been attracting plenty of research interest lately. Recently, I wrote about the United States's worst-in-the-industrialized-world rank for preventing premature deaths, and I also reported on our less-than-impressive tally of states that require insurance coverage of colonoscopy tests to screen for colon cancer. Now here we are again. Nobody likes being reminded of life's certainties—at tax time, no less—but death is one event we ought to be able to, if not avoid, at least not hasten because of inadequate health coverage.