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The Impact of Increasing Health Insurance Coverage on Disparities in Mortality

Health Care Reform in Colombia, 1998–2007

Bibliographic Data

ID11039690
AuthorsIvan Arroyave (0000-0001-9989-5833, Ivan Arroyave is with Erasmus University Medical Center, Rotterdam, The Netherlands; the Public Health Observatory, Faculty of Medicine, Universidad CES, Medellin, Colombia; and the Epidemiology Research Group, National School of Public Health, Universidad de Antioquia, Medellin. Mauricio Avendano is with the London School of Economics and Political Science, Department of Social Policy, the Department of Public Health of the Erasmus University Medical Center, and the Department of Society, Human...), Doris Cardona-Arango (0000-0003-4338-588X, Clínica CES), Doris Cardona (Ivan Arroyave is with Erasmus University Medical Center, Rotterdam, The Netherlands; the Public Health Observatory, Faculty of Medicine, Universidad CES, Medellin, Colombia; and the Epidemiology Research Group, National School of Public Health, Universidad de Antioquia, Medellin. Mauricio Avendano is with the London School of Economics and Political Science, Department of Social Policy, the Department of Public Health of the Erasmus University Medical Center, and the Department of Society, Human...), Alex Burdorf (0000-0003-3129-2862, Ivan Arroyave is with Erasmus University Medical Center, Rotterdam, The Netherlands; the Public Health Observatory, Faculty of Medicine, Universidad CES, Medellin, Colombia; and the Epidemiology Research Group, National School of Public Health, Universidad de Antioquia, Medellin. Mauricio Avendano is with the London School of Economics and Political Science, Department of Social Policy, the Department of Public Health of the Erasmus University Medical Center, and the Department of Society, Human...), Mauricio Avendaño (0000-0002-7295-2911, Ivan Arroyave is with Erasmus University Medical Center, Rotterdam, The Netherlands; the Public Health Observatory, Faculty of Medicine, Universidad CES, Medellin, Colombia; and the Epidemiology Research Group, National School of Public Health, Universidad de Antioquia, Medellin. Mauricio Avendano is with the London School of Economics and Political Science, Department of Social Policy, the Department of Public Health of the Erasmus University Medical Center, and the Department of Society, Human...)
Year2013
Volume103
Issue3
Pagese100-e106
Publication date2013-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2012.301143
PMID23327277
PMCIDPMC3673514
OpenAlexW2099889911
LanguageEN
Citations received5
References cited25

Objectives. We examined the impact of expanding health insurance coverage on socioeconomic disparities in total and cardiovascular disease mortality from 1998 to 2007 in Colombia. Methods. We used Poisson regression to analyze data from mortality registries (633 905 deaths) linked to population census data. We used the relative index of inequality to compare disparities in mortality by education between periods of moderate increase (1998–2002) and accelerated increase (2003–2007) in health insurance coverage. Results. Disparities in mortality by education widened over time. Among men, the relative index of inequality increased from 2.59 (95% confidence interval [CI] = 2.52, 2.67) in 1998–2002 to 3.07 (95% CI = 2.99, 3.15) in 2003–2007, and among women, from 2.86 (95% CI = 2.77, 2.95) to 3.12 (95% CI = 3.03, 3.21), respectively. Disparities increased yearly by 11% in men and 4% in women in 1998–2002, whereas they increased by 1% in men per year and remained stable among women in 2003–2007. Conclusions. Mortality disparities widened significantly less during the period of increased health insurance coverage than the period of no coverage change. Although expanding coverage did not eliminate disparities, it may contribute to curbing future widening of disparities

Census · Confidence interval · Environmental health · Health care · Health equity · Inequality · Poisson regression · Population · Public health · Socioeconomic status · Demography · Healthcare Systems and Reforms · Insurance, Mortality, Demography, Risk Management · Medicine · Primary Care and Health Outcomes

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Unique citing works5
Citations per year0,42
Citation span2014 - 2024 (11)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 4

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