The impact of increasing health insurance coverage on disparities in mortality: Health care reform in Colombia, 1998-2007

I. Arroyave, D. Cardona, A. Burdorf and M. Avendano

American Journal of Public Health, 2013, vol. 103, issue 3, e100-e106

Abstract: 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 from2.59 (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.

Keywords: adult; age; article; Colombia; educational status; female; health care policy; health disparity; health insurance; human; insurance; male; middle aged; mortality; sex difference; statistics, Adult; Age Factors; Colombia; Educational Status; Female; Health Care Reform; Health Status Disparities; Humans; Insurance Coverage; Insurance, Health; Male; Middle Aged; Mortality; Sex Factors (search for similar items in EconPapers)
Date: 2013
References: Add references at CitEc
Citations: View citations in EconPapers (5)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2012.301143

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.301143_1

DOI: 10.2105/AJPH.2012.301143

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().