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Health Insurance Coverage Among U.S. Workers: Differences by Work Arrangements in 2010 and 2015

  • Chia-ping Su
    Affiliations
    Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia

    Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
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  • Abay Asfaw
    Affiliations
    Office of the Director, Economic Research and Support Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, District of Columbia
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  • Sara L. Tamers
    Affiliations
    Office of the Director, Office for Total Worker Health, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, District of Columbia
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  • Sara E. Luckhaupt
    Correspondence
    Address correspondence to: Sara E. Luckhaupt, MD, MPH, Centers for Disease Control and Prevention, 1090 Tusculum Avenue, MS R-17, Cincinnati OH 45226.
    Affiliations
    Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
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      Introduction

      For most Americans, health insurance is obtained through employers. Health insurance coverage can lead to better health outcomes, yet disparities in coverage exist among workers with different sociodemographic and job characteristics. This study compared uninsured rates among workers with different work arrangements.

      Methods

      Data from the 2010 and 2015 National Health Interview Survey–Occupational Health Supplements were used to capture a representative sample of the U.S. civilian, non-institutionalized population. Associations between work arrangement and lack of health insurance were analyzed, adjusting for covariates. Analyses were performed during 2016–2018.

      Results

      The percentage of workers aged 18–64years without health insurance coverage decreased significantly by 6.8% among workers in all work arrangement categories between 2010 and 2015. However, workers in nonstandard work arrangements were still more likely than standard workers to have no health insurance coverage. In 2015, for workers to have no health insurance the ORs were 4.92 (95% CI=3.91, 6.17) in independent, 2.87 (95% CI=2.00, 4.12) in temporary or contract, and 2.79 (95% CI=0.34, 0.41) in other work arrangements. Standard full-time workers in small establishments and standard part-time workers were also more likely to have no health insurance coverage (OR=2.74, 95% CI=2.27, 3.31, and OR=1.65, 95% CI=1.25, 2.18, respectively).

      Conclusions

      Important disparities in health insurance coverage among workers with different work arrangements existed in 2010 and persisted in 2015. Further research is needed to monitor coverage trends among workers.
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