IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i5p1525-d325721.html
   My bibliography  Save this article

The Association between Health Insurance and All-Cause, Cardiovascular Disease, Cancer and Cause-Specific Mortality: A Prospective Cohort Study

Author

Listed:
  • Liying Song

    (School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710061, China)

  • Yan Wang

    (School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710061, China
    Mianyang Taxation Bureau of Sichuan Province, State Taxation Administration, Mianyang 621000, China)

  • Baodong Chen

    (Department of Accounting, School of Management, Xi’an Polytechnic University, No.19, Jinhua South Road, Xincheng District, Xi’an 710048, China)

  • Tan Yang

    (School of Finance and Accounting, Xi’an University of Technology, No. 58, Yanxiang Road, Yanta District, Xi’an 710054, China)

  • Weiliang Zhang

    (School of Economics and Finance, Xi’an International Studies University, South Wenyuan Road, Chang’an District, Xi’an 710128, China)

  • Yafeng Wang

    (Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China)

Abstract

The purpose of this study was to evaluate the association of insurance status with all-cause and cause-specific mortality. A total of 390,881 participants, aged 18–64 years and interviewed from 1997 to 2013 were eligible for a mortality follow-up in 31 December 2015. Cox proportional hazards models were used to calculate the hazards ratios (HR) and 95% confidence intervals (CI) to determine the association between insurance status and all-cause and cause-specific mortality. The sample group cumulatively aged 4.22 million years before their follow-ups, with a mean follow-up of 10.4 years, and a total of 22,852 all-cause deaths. In fully adjusted models, private insurance was significantly associated with a 17% decreased risk of mortality (HR = 0.83; 95% CI = 0.80–0.87), but public insurance was associated with a 21% increased risk of mortality (HR = 1.21; 95% CI = 1.15–1.27). Compared to noninsurance, private coverage was associated with about 21% lower CVD mortality risk (HR = 0.79, 95% CI = 0.70–0.89). In addition, public insurance was associated with increased mortality risk of kidney disease, diabetes and CLRD, compared with noninsurance, respectively. This study supports the current evidence for the relationship between private insurance and decreased mortality risk. In addition, our results show that public insurance is associated with an increased risk of mortality.

Suggested Citation

  • Liying Song & Yan Wang & Baodong Chen & Tan Yang & Weiliang Zhang & Yafeng Wang, 2020. "The Association between Health Insurance and All-Cause, Cardiovascular Disease, Cancer and Cause-Specific Mortality: A Prospective Cohort Study," IJERPH, MDPI, vol. 17(5), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1525-:d:325721
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/5/1525/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/5/1525/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Takaaki Ikeda & Kemmyo Sugiyama & Jun Aida & Toru Tsuboya & Ken Osaka, 2019. "The Contextual Effect of Area-Level Unemployment Rate on Lower Back Pain: A Multilevel Analysis of Three Consecutive Surveys of 962,586 Workers in Japan," IJERPH, MDPI, vol. 16(20), pages 1-11, October.
    2. So-Hyun Moon & Hyun-Ju Seo & Dong Young Lee & Seong Min Kim & Jeong Min Park, 2019. "Associations Among Health Insurance Type, Cardiovascular Risk Factors, and the Risk of Dementia: A Prospective Cohort Study in Korea," IJERPH, MDPI, vol. 16(14), pages 1-9, July.
    3. Wilper, A.P. & Woolhandler, S. & Lasser, K.E. & McCormick, D. & Bor, D.H. & Himmelstein, D.U., 2009. "Health insurance and mortality in US adults," American Journal of Public Health, American Public Health Association, vol. 99(12), pages 2289-2295.
    4. Weathers, Robert R. & Stegman, Michelle, 2012. "The effect of expanding access to health insurance on the health and mortality of Social Security Disability Insurance beneficiaries," Journal of Health Economics, Elsevier, vol. 31(6), pages 863-875.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Duncan Gillespie & Meredith Trotter & Shripad Tuljapurkar, 2014. "Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1003-1017, June.
    2. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    3. Chang-Gyu Yang & Silvana Trimi & Sang-Gun Lee & Joon-Sun Yang, 2017. "A Survival Analysis of Business Insolvency in ICT and Automobile Industries," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 16(06), pages 1523-1548, November.
    4. Black, Bernard & Hollingsworth, Alex & Nunes, Letícia & Simon, Kosali, 2022. "Simulated power analyses for observational studies: An application to the Affordable Care Act Medicaid expansion," Journal of Public Economics, Elsevier, vol. 213(C).
    5. J Dustin Tracy & Kevin A James & Hillard Kaplan & Stephen Rassenti, 2021. "An investigation of health insurance policy and behavior in a virtual environment," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-26, April.
    6. Bernard Black & José-Antonio Espín-Sánchez & Eric French & Kate Litvak, 2017. "The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality," American Journal of Health Economics, University of Chicago Press, vol. 3(3), pages 281-311, Summer.
    7. Rohde, Nicholas & Tang, Kam Ki & Osberg, Lars & Rao, D.S. Prasada, 2017. "Is it vulnerability or economic insecurity that matters for health?," Journal of Economic Behavior & Organization, Elsevier, vol. 134(C), pages 307-319.
    8. Moore, Timothy J., 2015. "The employment effects of terminating disability benefits," Journal of Public Economics, Elsevier, vol. 124(C), pages 30-43.
    9. Michael A McClurkin & Leah Rae Yingling & Colby Ayers & Rebecca Cooper-McCann & Visakha Suresh & Ann Nothwehr & Debbie S Barrington & Tiffany M Powell-Wiley, 2015. "Health Insurance Status as a Barrier to Ideal Cardiovascular Health for U.S. Adults: Data from the National Health and Nutrition Examination Survey (NHANES)," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-14, November.
    10. Su Jung Lee & Hyun-Ju Seo & Dong Young Lee & So-Hyun Moon, 2019. "Effects of a Dementia Screening Program on Healthcare Utilization in South Korea: A Difference-In-Difference Analysis," IJERPH, MDPI, vol. 16(20), pages 1-13, October.
    11. Ethan C Cicero & Sari L Reisner & Elizabeth I Merwin & Janice C Humphreys & Susan G Silva, 2020. "The health status of transgender and gender nonbinary adults in the United States," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-20, February.
    12. Quan-Hoang Vuong & Tung-Manh Ho & Hong-Kong Nguyen & Thu-Trang Vuong, 2018. "Healthcare consumers’ sensitivity to costs: a reflection on behavioural economics from an emerging market," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-10, December.
    13. Klein, Alexander & Crafts, Nicholas, 2023. "Unconditional Convergence in Manufacturing Productivity across U.S. States: What the Long-Run Data Show," CEPR Discussion Papers 18065, C.E.P.R. Discussion Papers.
    14. Hongfeng Zhang & Peng Cheng & Lu Huang, 2023. "The Impact of the Medical Insurance System on the Health of Older Adults in Urban China: Analysis Based on Three-Period Panel Data," IJERPH, MDPI, vol. 20(5), pages 1-17, February.
    15. Black, Bernard & French, Eric & McCauley, Jeremy & Song, Jae, 2024. "The effect of disability insurance receipt on mortality," Journal of Public Economics, Elsevier, vol. 229(C).
    16. Scott E. Harrington, 2010. "The Health Insurance Reform Debate," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 5-38, March.
    17. Shao, Yaxiong & Luo, Wei, 2022. "Supply-demand adjusted two-steps floating catchment area (SDA-2SFCA) model for measuring spatial access to health care," Social Science & Medicine, Elsevier, vol. 296(C).
    18. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1783-1829.
    19. Christina J. Diaz & Liwen Zeng & Ana P. Martinez-Donate, 2018. "Investigating Health Selection Within Mexico and Across the US Border," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(2), pages 181-204, April.
    20. Sarah E. Dehry & Patrick M. Krueger, 2023. "Excess Deaths in the United States Compared to 18 Other High-Income Countries," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(2), pages 1-14, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1525-:d:325721. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.