Unmet Health Needs of Uninsured Adults in the United States

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Abstract
In 1998, approximately 44 million Americans younger than 65 years—nearly one fifth of the nonelderly population—lacked health insurance, including 33 million adults aged 18 to 64 years.1 Prior studies have documented that lacking health insurance is associated with important clinical consequences.2-4 Uninsured adults generally encounter greater barriers to preventive services and treatment of chronic illnesses than to acute care.5 They are more likely than insured adults to report poor health status,6-8 delay seeking medical care,9 and forgo necessary care for potentially serious symptoms.10 Uninsured adults receive fewer screening services for cancer and cardiovascular risk factors,11-14 present with later-stage diagnoses of cancer,15,16 and experience more avoidable hospitalizations.17 They also face an increased risk of death,18 particularly when hospitalized19 or diagnosed as having breast cancer.15