Insured Americans have healthier lifestyles than uninsured
■ People without health insurance are more likely to smoke and generally have less healthy habits than people with coverage, Gallup reports show.
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People with health insurance are less likely to smoke and more likely to exercise regularly and eat a healthy diet than those without insurance, according to Gallup Poll data released in December 2011.
Individuals with insurance also rate their overall health better than people without coverage, say the two reports, which are based on 199,672 interviews with U.S. adults ages 18 to 64, conducted from January to October 2011. The reports are part of ongoing research examining the implications of health insurance coverage.
The goal is to foster discussion about the many factors that affect health, including where people live and work, said Magali Rheault, co-author of the reports and senior consultant for Gallup.
"We want to look at well-being in a more comprehensive way," she said.
Though the data demonstrate a link between health coverage and good health habits, they do not show a clear connection between better health and insurance coverage, Rheault said. Survey respondents were diagnosed with specific medical conditions at similar rates, regardless of insurance coverage.
For example, 24% of those with insurance said they had hypertension, compared with 22% for the uninsured. Five percent of insured respondents said they had been diagnosed with cancer compared with 3% of uninsured, the reports say.
"We could see that people who are insured are more likely to assess their health more positively," Rheault said. "It is not so clear when it comes to actual health outcomes."
Differences in access to care
Overall, 51% of people with insurance said they had been diagnosed with at least one of seven common health conditions, compared with 47% of those without insurance.
The discrepancy may be due to the fact that people with insurance have greater access to care. People without insurance may have medical conditions that have not been diagnosed, the reports said. Insured Americans were more than twice as likely as the uninsured to say they have a personal physician.
The most valuable data from the research concern people's opinion of their own health, said Peter Beilenson, MD, MPH, director of the Howard County (Md.) Health Dept. "A big part of health is your own sense of well-being," he said.
Though the survey results provide insight into people's opinions, many scientific studies show that people with health insurance are healthier overall than the uninsured, Dr. Beilenson said.
There are multiple social determinants of health that could influence the lifestyle habits of the uninsured. People without coverage are more likely to be poor and live in low-income areas without grocery stores that sell fresh produce, he said. Poorer neighborhoods also are more likely to be crime-ridden, and an uninsured person may not feel safe going outside to walk or exercise.
Compared with the uninsured, more people with insurance have an ongoing relationship with a family physician who can help monitor their health and diagnose and treat any conditions that may arise, said Glen Stream, MD, president of the American Academy of Family Physicians.
"Being uninsured is a significant risk factor for poor health," Dr. Stream said. "Twenty percent of people said they did not have health insurance. That's a lot of people. There is a substantial amount of illness and disease that is associated with this one factor."