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Outrage of the Month: Preventable Death and Lack of Insurance

Health Letter, October 2013

By Sidney M. Wolfe, M.D.


If you’re not outraged,
you’re not paying attention!

Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.

Last month, the federal Centers for Disease Control and Prevention (CDC) published for the first time an analysis of changing patterns of preventable deaths from heart disease, stroke and hypertension. CDC found more than 200,000 avoidable deaths in 2010 about one-fourth of the 800,000 annual deaths from these diseases. These preventable deaths disproportionately occurred among non-Hispanic blacks and residents of the South.

The good news was that between 2001 and 2010, the number of preventable deaths due to heart disease and stroke declined in people aged 65 to 74 years. “This may well be because they have access to health insurance and preventive screenings and treatment through their Medicare coverage,” CDC Director Dr. Thomas Frieden said.

The bad news was that preventable deaths have fallen more slowly in those under age 65. More than half (56 percent) of preventable heart disease and stroke deaths occurred in this younger age group.

One important facet of the study is vastly different access to health care, dependent on age. The report stated:

Whereas the percentage of adults aged 18–64 years with no health insurance increased from 17% in 2001 to 22% in 2010, it remained at less than 2% among adults aged 65 years or older (because of Medicare coverage in this population)…. The increase in percentage without insurance among the younger age groups might have limited their access to preventive screenings and early treatment of high blood pressure and elevated cholesterol….

The report also noted that “compared with persons aged 60 years or older, during 2009–2010, adults aged 18–39 years with high blood pressure experienced much lower rates of treatment and control and saw no improvements in those rates from 2001 to 2010.”

The effects of going without health insurance are deadly for the 48 million people uninsured in this country. Unlike most developed countries, health care is not a basic right here. Although there will be some modest improvement with the Affordable Care Act, an estimated 20 to 30 million people will still be uninsured and therefore at increased risk of death, even after the law is implemented. This is why we and a growing number of people strongly prefer a single payer health care system, also known as improved Medicare for All.