Adults who report frequent mental distress – regardless of whether it’s accompanied by physical stress – are far more likely to be uninsured than those reporting only physical distress or none at all, according to researchers at the Centers for Disease Control and Prevention.
Almost one-quarter (22.6%) of survey respondents reporting frequent mental distress or both frequent mental and physical distress (21.8%) said they lacked health insurance, the researchers reported Oct. 3 in Psychiatric Services. Meanwhile, in the four surveys making up the study, only 17.7% of people reporting frequent physical distress and 16.6% of people reporting no distress said they were without health insurance (Psychiatr. Serv. 2011;62:1131-7).
The incidence of frequent mental distress may affect an individual’s insurance prospects over time, said the authors, including researchers at the CDC and Emory University, Atlanta.
"The prevalence of uninsurance did not differ markedly between those with only frequent mental distress and those with both frequent mental distress and frequent physical distress, suggesting that frequent mental distress may be the driving factor in the prevalence of uninsurance in this population," they wrote.
Among people with mental distress, members of several groups – including adults with less than a high school education and blacks and Hispanics – were more likely to lack health insurance. For example, 40% of adults without a high school diploma who had frequent mental distress lacked health insurance, and 35% of Hispanics with frequent mental distress were without coverage, the researchers found.
The proportion of adults with frequent mental distress who were uninsured increased between 1993, when the CDC did the first survey, and 2009, the year of the most recent survey: 21.6% of adults with frequent mental distress were uninsured in 1993 and 23.8% were in 2009. Women, people aged 18-34, white non-Hispanics, and high school graduates saw the greatest decreases in insurance coverage. Healthy young adults without mental or physical distress also declined in insurance coverage, indicating members of this age group "increasingly have chosen to opt out of buying health insurance," the authors reported.
It’s not clear why people with frequent mental distress lack health insurance coverage more often than people who don’t suffer such a mental health problem, the researchers said. It’s possible that insurers may be denying coverage to people with frequent mental distress, they speculated. Or being without enough money to purchase health insurance might lead to mental distress.
"Persons with frequent physical or mental distress or both may not seek health insurance coverage or may be denied insurance because of a preexisting condition, or people who cannot afford insurance may be more likely to subsequently develop frequent distress," the report concluded.
The authors reported having no conflict of interest.