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COVERAGE: Chronic Disease: The Heat Is On the Uninsured

Throw another log on the burden of chronic disease fire:

About one-in-three working age Americans without insurance has at least one chronic illness, according to a new study published today in the Annals of Internal Medicine (abstract) and picked up in the New York Times.

Examining data from the National Health and Nutrition Examination Survey, the authors found that in 2004 (the latest year of the study) about  11.4 million, of the 36.4 million uninsured Americans between the ages of 18 and 64 were chronically ill.

The prevalence of chronic disease among the uninsured shouldn't surprise many, considering the CDC estimates that 133 million Americans suffer from at least one chronic disease. For a quick refresher on who is uninsured, check out New America's policy brief.

The study's more valuable contribution is demonstrating the significant barriers to care faced by chronically ill uninsured. Compared to the chronically ill with insurance:

  • 22.6 percent of the uninsured (vs. 6.2 percent of the insured) had not visited a health professional in the past year
  • 26.1 percent (vs. 6.2 percent) did not have a standard site for care
  • 7.1 percent (vs. 1.1 percent) listed the emergency room as a standard site of care

We've written in the past about the burden of chronic disease which accounts for seven out of every 10 deaths and $1 trillion a year in lost productivity. These facts alone are scary enough for a campfire. As we've noted in the past, insurance clearly matters to healthy individuals and society. This study illustrates such arguments are especially true when it comes to the treatment and management of chronic disease. The challenge of chronic disease is intricately related to the goals of sustainable health reform. Both will require a comprehensive approach—one that provides access to care for all Americans and ensures that such care is delivered in an integrated system where providers are paid for the quality, and not just the quanity of care.

Reformers didn't start the chronic disease fire in America today. But they most certainly need to try to fight it.