Well-Being

In U.S., Health Insurance Not Necessarily Related to Health

by Magali Rheault and Kyley McGeeney

Those with health coverage more than twice as likely as those without to have a doctor

This is the first in a series of articles about health insurance coverage in America among adults aged 18 to 64. Part one looks at the relationship between health insurance status and Americans' health. Part two will explore whether having health insurance influences Americans' smoking, eating, and exercise habits.

WASHINGTON, D.C. -- Americans aged 18 to 64 with health insurance rate their overall health far more positively than those without coverage. Nearly 6 in 10 Americans younger than 65 with health insurance rate their health as either "excellent" or "very good," compared with 36% of those in the same age group without coverage. This relationship holds when controlling for socio-economic demographics such as age, education, and income.

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These findings are based on nearly 200,000 interviews conducted from January through October 2011 as part of the Gallup-Healthways Well-Being Index. Overall, 80% of Americans aged 18 to 64 report having health insurance coverage. This percentage is higher among the employed and those in upper-income groups.

Insured Americans Far More Likely to Have a Doctor

Insured Americans are more than twice as likely as the uninsured to say they have a personal doctor (85% versus 37%).

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Perhaps reflecting their greater access to medical professionals, those with health insurance are slightly more likely than those without to report having ever been told by a doctor they had at least one of the following medical conditions the Gallup-Healthways Well-Being Index tracks: high blood pressure, high cholesterol, depression, asthma, diabetes, cancer, or a heart attack. Because those with health insurance are more likely than those without to receive clinical diagnoses of these conditions, they may have greater awareness of their objective health status compared with those who lack such coverage.

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However, looking at the specific conditions individually by health insurance status reveals that those with coverage are only more likely to report having ever been diagnosed with high cholesterol than those without. The uninsured, in fact, are more likely than the insured to report having been told by a doctor or nurse at some point that they have depression. But for all other clinically diagnosed conditions in the survey, there are no statistically significant differences based on health coverage status.

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Bottom Line

Health insurance coverage appears to be related to self-ratings of health. Insured Americans, at least those younger than 65, assess their general health more positively than the uninsured. This may be because the insured are more aware of their actual health situation because of their greater access to a physician or that they may take greater care in maintaining their health, which could include regular doctor visits.

However, the relationship between health insurance and actual physical health is not as clear. Those with health insurance are more likely than those without insurance to report having being diagnosed at some point with at least one of the medical conditions or diseases in the Gallup-Healthways Well-Being Index survey.

In particular, the insured are far more likely than the uninsured to report having ever been diagnosed with high cholesterol. This may reflect the greater access to healthcare professionals the insured have. It is not clear if those without health insurance are actually less likely to have high cholesterol. It may be that they do not know if they have the condition.

About the Gallup-Healthways Well-Being Index

The Gallup-Healthways Well-Being Index tracks wellbeing in the U.S., U.K., and Germany and provides best-in-class solutions for a healthier world. To learn more, please visit well-beingindex.com.

Survey Methods

Results are based on telephone interviews conducted as part of the Gallup-Healthways Well-Being Index survey Jan. 2-Oct. 27, 2011, with a random sample of 199,672 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, selected using random-digit-dial sampling.

For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±1 percentage point. Margins of error for subgroups have a maximum margin of sampling error of ±3 percentage points.

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample includes a minimum quota of 400 cell phone respondents and 600 landline respondents per 1,000 national adults, with additional minimum quotas among landline respondents by region. Landline telephone numbers are chosen at random among listed telephone numbers. Cell phone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.

Samples are weighted by gender, age, race, Hispanic ethnicity, education, region, adults in the household, and phone status (cell phone only/landline only/both, cell phone mostly, and having an unlisted landline number). Demographic weighting targets are based on the March 2010 Current Population Survey figures for the aged 18 and older non-institutionalized population living in U.S. telephone households. All reported margins of sampling error include the computed design effects for weighting and sample design.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup's polling methodology, visit www.gallup.com.


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