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(NaturalNews) A study recently published in the Annals of Internal Medicine found that millions of working-age persons in the United States who suffer from chronic health conditions do not have insurance coverage and have poorer access to medical care as compared to their insured counterparts.

Details of Study

The study looked at data from the National Health and Nutritional Examination Survey (NHANES) (1999-2004) in the United States and took into account estimated rates of various illnesses, such as asthma, previous cancer, cardiovascular disease, diabetes, hypertension and obstructive lung disease, as well as measures of healthcare access. Those studied ranged from age 18 to 64.

Findings

Based on those statistics, the study team estimated that 11.4 million Americans of working age who suffered from chronic health conditions did not have insurance. This means that almost one in three adults of working age who did not have insurance coverage had been diagnosed with a chronic disease –- there were about 36 million uninsured Americans in 2004. And a number of these people may even have had multiple chronic illnesses.

This included about 16% of the 7.8 million who had cardiovascular disease, 15.5% of the 38.2 million with hypertension, and more than 16.5% of the 8.5 million who suffered from diabetes.

Further, when factors such as age, ethnicity and gender were controlled, persons who were chronically ill but not insured were more than three times more likely not to have consulted a health professional (22.6% against 6.2%) and more than four times more likely not to have had a standard site for medical care (26.1% against 6.2%) in the past 12 months, when compared to those with insurance coverage. On the other hand, they were much more likely (7.1% against 1.1%) to have reported using an emergency department as a standard site for medical care.

Given these numbers, it was also quite likely that a significant number of the uninsured actually did suffer from some kind of yet-to-be-diagnosed chronic condition.

Why did so many Americans of working-age not have insurance coverage?

The researchers put forth a few possible reasons for the high proportion of uninsured working-age Americans. These included the decreasing size of many American companies and employer-sponsored coverage being eroded by the decline in manufacturing jobs.

Increasing premiums might worsen the situation, as it would discourage companies from covering their employees, discourage participation by workers who were required to co-pay insurance premiums, as well as make insurance much more unaffordable for those who were self-employed, especially if they were already diagnosed with a chronic condition.

Limitations of Study

It is worthwhile to note that this study had several limitations. For example, data from the NHANES excluded individuals who did not speak English or Spanish. Also, insurance status was self-reported, and could not be verified by the researchers.

In addition, it was probable that the health issues of uninsured Americans were underestimated because those who did not have insurance had a lower likelihood of knowing they had an illness, partly since they did not visit the doctor's office often in the first place. Details of health insurance plans were also excluded.

How it all adds up

Despite its limitations, this study is significant because the rates of chronic sickness among uninsured Americans had previously not been well documented, and its findings are not consistent with the claim that people who are not insured are largely young and healthy people with little or no need for medical care. This is a belief which is held even by some government officials.

This study has presented to us a grim picture of the reality today, that millions of Americans who suffer from chronic conditions like diabetes and hypertension are not getting the ongoing medical attention and treatment that they need because they do not have medical insurance.

And this poor access to medical care may have serious consequences for many. "A lot of people are suffering from a lack of health insurance," said Dr. Steffie Woolhandler, part of the study team and a physician and associate professor of medicine at Harvard.

Those with hypertension, for instance, would be at higher risk of getting a stroke without the help of a doctor or drugs to monitor and manage their condition.

The study team summed up the gravity of the situation when it stated that "among chronically ill persons, lack of health insurance is strongly associated with poor measures of access to care. For some of the 11.4 million uninsured Americans with serious chronic conditions, access to care seems to be unobtainable; many may face early disability and death as a result".

"These are people who, with modern therapies, can be kept out of trouble," added Dr. Andrew P. Wilper, the leader of the study and a medical instructor at the University of Washington in Seattle. In addition, he described treatments for diabetes and hypertension as "routine and widely available, if you have insurance".

Another implication of the high rates of chronic disease among the uninsured is that costs for medically insuring them would come up to be much higher than expected.

Latest figures

Latest government statistics estimate that about 47 million Americans do not have insurance coverage. Using the findings of the study and assuming the proportion with chronic illnesses remain roughly the same, there could be nearly 16 million Americans today who are chronically ill but who are unable to pay for medical attention using insurance.

What next?

The study team, besides suggesting further scope for research, said that it was important for future research to look into ways of expanding medical insurance coverage.

In the meantime, although doctors have said that conventional medical care can help with many chronic health conditions, it is necessary for you and me, as well as the general public, to begin to take personal responsibility for our health and make the necessary changes to our dietary and lifestyle habits.

In fact, only by doing this can we attain the best prevention and have real hope of true recovery from chronic diseases.

Main Sources

A National Study of Chronic Disease Prevalence and Access to Care in Uninsured U.S. Adults (http://www.annals.org/cgi/content/f...)

Millions With Chronic Disease Get Little to No Treatment (http://www.nytimes.com/2008/08/05/b...)

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