Statement of the problem: Disparities in life expectancy between white and non-white populations in the US have declined only slightly during the past twenty years. Uninsurance in middle-aged adults has been associated with premature death, and may contribute to disparities in mortality. Some proposed Medicaid expansions do not address this age group.

Project goals: The purpose of the mortality analysis project is to provide estimates of the effect of lack of health insurance on premature mortality among adults aged 45-64. Specifically, we propose to estimate mortality rates across urban and rural populations, by sex and race-ethnicity, and assess the degree to which mortality rates are influenced by insurance status.

Methods: Our research will use the nationally representative Linked Mortality File, developed by the National Center for Health Statistics. This file links detailed respondent information obtained by the 1986 - 2000 National Health Interview Surveys with the National Death File. It contains vital status follow-up information for 297,246 persons age 45 -64.

Anticipated publications or products: A Research Product Portfolio consisting of a Technical Report, Executive Summary, Key Facts Sheet, and postcard, will be provided to the Office of Rural Health Policy (ORHP). Scientific presentations and papers will target key policy venues such as AcademyHealth and journals such as Health Affairs.

Publications

• Higher Risk of Death in Rural Blacks and Whites Than Urbanites Is Related to Lower Incomes, Education, and Health Coverage
  Journal Article
  Rural and Minority Health Research Center
  Date: 10/2011
  Explores the degree to which lack of health insurance may contribute to high mortality rates among rural minority men and women aged 45-64.