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January 2003, Vol 93, No. 1 | American Journal of Public Health 130-137
© 2003 American Public Health Association

RESEARCH AND PRACTICE

Intermittent Lack of Health Insurance Coverage and Use of Preventive Services

Joseph J. Sudano, Jr, PhD and David W. Baker, MD, MPH

Joseph J. Sudano Jr is with the Center for Health Care Research and Policy, Case Western Reserve University at the MetroHealth System, and the Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio. David W. Baker is with the Feinberg School of Medicine, Northwestern University, Evanston, Ill.

Correspondence: Requests for reprints should be sent to Joseph J. Sudano Jr, PhD, MetroHealth System, Rammelkamp 236, 2500 MetroHealth Dr, Cleveland, OH 44109-1998 (e-mail: jsudano{at}metrohealth.org).

Objectives. This study examined the association between intermittent lack of health insurance coverage and use of preventive health services.

Methods. Analyses focused on longitudinal data on insurance status and preventive service use among a national sample of US adults who participated in the Health and Retirement Study.

Results. Findings showed that, among individuals who obtain insurance coverage after histories of intermittent coverage, relatively long periods may be necessary to reestablish clinically appropriate care patterns. Increasing periods of noncoverage led to successively lower rates of use of most preventive services.

Conclusions. Intermittent lack of insurance coverage—even across a relatively long period—results in less use of preventive services. Studies that examine only current insurance status may underestimate the population at risk from being uninsured.




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