Health CareCoverage andUseof Preventive Services AmongtheNear Elderly intheUnited States

IntheUnited States inthefirst half of 1996, anestimated 44.5million persons younger than65years werewithout health insurance.' Thenumber ofAmericans with nocoverage isalong-standing policy concernbecause research findings indicate a relationship between lack ofhealth insurance anduseofpreventive services, delay inseekingmedical care, andpoorhealth status.2'3 Previous research findings suggest that being uninsured maybeassociated with declines in health status.4 Inaddition, hospitalized patients whohavenocoverage mayreceive fewer inpatient services andmaybeathigher risk ofdying than those whoareinsured.5'6 Forthese reasons, lack ofhealth insurance coverage mayresult insubstantial increases inthenumber ofpeople with chronic conditions andthecost ofproviding care forsuch individuals. Lackofhealth insurance isaparticularly