Research released this week in the American Journal of Public Health estimates that 45,000 deaths per year in the United States are associated with the lack of health insurance. If a person is uninsured, "it means you're at mortal risk," said one of the authors, Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School.
The researchers examined government health surveys from more than 9,000 people aged 17 to 64, taken from 1986-1994, and then followed up through 2000. They determined that the uninsured have a 40 percent higher risk of death than those with private health insurance as a result of being unable to obtain necessary medical care. The researchers then extrapolated the results to census data from 2005 and calculated there were 44,789 deaths associated with lack of health insurance.
For years, Paul Hannum didn't have health insurance while he worked as a freelance cameraman in southern California.
One Sunday, Hannum complained of a stomachache which alarmed his pregnant fiancée, Sarah Percy. "He wasn't a complainer," she said. "He's the type of guy who, if he got a cold, he'll power through it. I never had known him to complain about anything."
Hannum thought he had a stomach flu or food poisoning from bad chicken. On Monday, his brother saw him looking ashen and urged him to go to the hospital. "He had a little girl on the way," his older brother Curtis Hannum said. "He didn't want the added burden of an ER visit to hang on their finances. He thought 'I'll just wait,' and he got worse and worse."
By the time Hannum got to the hospital and was admitted to surgery, it was too late.
Paul Hannum, 45, died on Thursday, August 3, 2006, from a ruptured appendix. His daughter, Cameron was born two months later.
Sidney M. Wolfe, M.D.
The latest data from the U.S. Census Bureau has shown that, as of 2010, there were 50 million people in this country lacking health insurance. A 2009 study by Harvard researchers found that there was an excess mortality of 40 percent in uninsured people — compared to people with health insurance — because they don’t have health insurance. Combining this with the lower number of people then uninsured, the researchers estimated that almost 45,000 people died each year from causes attributable to their uninsured status.
Based on the larger number of uninsured now compared to when the Harvard study was done, there is little question that the annual number of deaths occurring because of a lack of health insurance is well over 50,000, a toll exceeding the annual number of deaths from kidney disease. Why is this tolerated? The simple and unfortunately correct answer is because of the existence of the private health insurance industry and the hundreds of thousands of people who are not doctors, not nurses and not pharmacists — in short, not delivering any health care — but are being paid for their expertise in denying health care. Reliable estimates of the cost of the excessive administrative waste of this health-denying insurance industry set the amount at approximately$400 billion a year. This amount of money is more than sufficient to provide — to the tune of $8,000 per year, per person — the current 50 million uninsured with excellent health coverage.
It is now 40 years since the wiser country of Canada threw out its private health insurance industry after an extremely successful 10-year single payer (Medicare-for-All) program in Saskatchewan. Maybe we will also need to try this in a state in the U.S. before we are able to go national. But we better get going soon, before we sacrifice the lives of many more hundreds of thousands in this country.
But by far the most dangerous occupation is no occupation — being unemployed. For this we use a study by Ray Marshall, former Secretary of Labor and now a professor at the University of Texas. Unemployment affects not only the worker himself, but his family and friends, and even those who remain employed because of stress caused by fear of losing their jobs. But if all of these effects were concentrated on the worker himself, the LLE from one year of unemployment would be about 500 days. This is about equal to the risk of smoking 10 packs of cigarettes per day while unemployed.
The unemployment rate in the United States frequently rises or falls by 1% or more. The estimated effects of a 1% increase for one year are 37,000 deaths, including 20,000 due to cardiovascular failure, 500 due to alcohol-related cirrhosis of the liver, 900 suicides, and 650 homicides. In addition to the deaths, there are 4,200 admissions to mental hospitals and 3,300 admissions to state prisons. Clearly, any action, or inaction, that can lead to increased unemployment is very dangerous. Importing oil rather than utilizing domestic energy production is such an action, and having inadequate supplies of electricity or allowing electricity costs to rise unnecessarily are such inactions.
Medical care is an obvious factor affecting life expectancy. If full use were made of available medical technology, it is estimated that 75,000 cancer deaths and 125,000 deaths from cardiovascular diseases could be prevented each year. Failure to achieve this performance by our medical care system is costing the average American an LLE of about 1.4 years.
It is estimated that if all currently available technology were used to prolong life, including good dietary practice, proper exercise and rest, and best available medical care, life expectancy would be increased by 9.5 years. Thus, sub-optimal lifestyles give us an LLE of 9.5 years. Over 20% of this is due to cigarette smoking. http://www.phyast.pitt.edu/~blc/book/chapter8.html
Objective To examine socioeconomic inequalities in rates of death from injury in children in England and Wales.
Design Analysis of rates of death from injury in children by the eight class version of the National Statistics Socio-Economic Classification (NS-SEC) and by the registrar general's social classification.
Setting England and Wales during periods of four years around the 1981, 1991, and 2001 censuses.
Subjects Children aged 0-15 years.
Main outcome measures Death rates from injury and poisoning.
Results Rates of death from injury in children fell from 11.1 deaths (95% confidence interval 10.8 to 11.5 deaths) per 100 000 children per year around the 1981 census to 4.0 deaths (3.8 to 4.2 deaths) per 100 000 children per year around the 2001 census. Socioeconomic inequalities remain: the death rate from all external causes for children of parents classified as never having worked or as long term unemployed (NS-SEC 8) was 13.1 (10.3 to 16.5) times that for children in NS-SEC 1(higher managerial/professional occupations). For deaths as pedestrians the rate in NS-SEC 8 was 20.6 (10.6 to 39.9) times higher than in NS-SEC 1; for deaths as cyclists it was 27.5 (6.4 to 118.2) times higher; for deaths due to fires it was 37.7 (11.6 to 121.9) times higher; and for deaths of undetermined intent it was 32.6 (15.8 to 67.2) times higher.
Conclusions Overall rates of death from injury and poisoning in children have fallen in England and Wales over the past 20 years, except for rates in children in families in which no adult is in paid employment. Serious inequalities in injury death rates remain, particularly for pedestrians, cyclists, house fires, and deaths of undetermined intent.
In the 1990s, Taichi Yoshida, the owner of a small moving company in Osaka, Japan, began noticing that many of his jobs involved people who had just died. Families of the deceased were either too squeamish to pack up for their dead relatives, or there wasn't any family to call on. So Yoshida started a new business cleaning out the homes of the dead. Then he started noticing something else: thick, dark stains shaped like a human body, the residue of liquids excreted by a decomposing corpse.
These, he learned, were kodokushi, or "lonely deaths." Now he has seen plenty — these deaths make up 300 of the 1,500 cleaning jobs performed by his company each year. The people die alone, sprawled on the floor beside crumpled clothing and dirty dishes, tucked beneath flowery bedspreads, slouched against the wall. Months — even years — can pass before somebody notices a body. On occasion, all that's left are bones. "The majority of lonely deaths are people who are kind of messy," says Yoshida. "It's the person who, when they take something out, they don't put it back; when something breaks, they don't fix it; when a relationship falls apart, they don't repair it."
In Japan, kodokushi
, a phenomenon first described in the 1980s, has become hauntingly common. In 2008 in Tokyo, more than 2,200 people over 65 died lonely deaths, according to statistics from the city's Bureau of Social Welfare and Public Health. The deaths most often involve men in their 50s and the nation's rapidly increasingly elderly population. Today, 1 in 5 Japanese is over 65; by 2030 it will be 1 in 3. With senior citizens increasingly living away from family and a nationwide shortage of nursing homes, many are now living alone. "There is a kind of myth that older people in Japan are living in three-generational families, but that's not so anymore," says Takako Sodei, a gerontologist with Ochanomizu University in Tokyo. (See pictures of Japan in the 1980s and today.)
Japan's two-decade economic slump is not helping. The collapse of the bubble economy after 1990 shrunk the size of Japanese firms and led to a restructuring that is still playing out today. The percentage of the workforce employed in part-time, temporary and contract work has tripled since 1990, forcing workaholic Japanese businessmen, many of whom never married, into a lonely early retirement. "Their world has evaporated under their feet," says Scott North, an Osaka University sociologist who studies Japanese work life. "The firm has been everything for these men. Their sense of manliness, their social position, their sense of self is all rooted in the corporate structure."