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Going bare: trends in health insurance coverage, 1989 through 1996
O Carrasquillo1, D U Himmelstein, S Woolhandler
1Department of Medicine, Cambridge Hospital/Harvard Medical School, Cambridge, Mass., USA. carraso@medicine1.cpmc.columbia.edu
American Journal of Public Health
|February 13, 1999
Summary
Health insurance coverage in the US declined from 1989 to 1996, increasing the uninsured population by 8.3 million. Young adults, children, and minority groups were disproportionately affected by rising rates of uninsurance.
Area of Science:
- Public Health
- Health Economics
- Sociology
Background:
- Health insurance coverage is a critical determinant of healthcare access and utilization.
- Understanding trends in insurance coverage is essential for public health policy and resource allocation.
Purpose of the Study:
- To analyze trends in health insurance coverage in the United States between 1989 and 1996.
- To identify demographic and socioeconomic groups most affected by changes in insurance status.
Main Methods:
- Analysis of annual cross-sectional survey data from the US Census Bureau.
- Examination of changes in the number and proportion of insured and uninsured individuals over time.
- Stratification of results by age, race/ethnicity, income level, and geographic region.
Main Results:
- The number of uninsured individuals in the US increased by 8.3 million between 1989 and 1996.
- Private insurance rates declined while Medicaid coverage increased from 1989 to 1993, with stabilization thereafter.
- Young adults (18-39), children, Black individuals, and Hispanic individuals experienced significant increases in uninsurance rates. The increase shifted from poor to middle-income families over time.
Conclusions:
- Despite economic growth, the uninsured population in the US continued to grow between 1989 and 1996.
- Children, young adults, poor and middle-income families, Black individuals, and Hispanic individuals were the most impacted populations.
- These findings highlight persistent disparities in health insurance coverage and underscore the need for targeted interventions.
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