Race, Health, Health Insurance Coverage in the U.S.: A Multistate Life Table Approach

James B. Kirby, Agency for Healthcare Research and Quality (AHRQ), HHS
Toshiko Kaneda, Population Reference Bureau

Wide racial disparities exist in health insurance coverage in the U.S. Available statistics on the number and proportion of uninsured Americans provide only a snapshot of the situation. This paper examines racial disparities in the lifetime burden of being uninsured. We construct multistate life tables that simultaneously classify health status and insurance status to estimate the expected years of life that Blacks and Whites live in different health-specific insurance states (e.g., healthy and insured, unhealthy and uninsured). We use data from the 2000 NCHS published period life tables and the 2000 Medical Expenditure Panel Survey. While being uninsured is problematic under any circumstances, those who are not healthy and uninsured are at a particular risk for poor financial and health outcomes. Our preliminary results suggest that there are even greater racial disparities in insurance coverage when we consider the lifetime disparities and distinction between healthy and unhealthy years of life.