The Impact of Health Insurance Coverage on Health Disparities in the United States

The United States leads the world in spending on health care, devoting 13% of national income to health, and more than twice as much per person as the OECD average. Yet despite this investment, countries spending substantially less than the US have healthier populations. America’s performance is marred by deep inequalities linked to income, health insurance coverage, race, ethnicity, geography, and – critically – access to care. Despite high levels of spending, some US health indicators are far below those that might be anticipated on the basis of national wealth. Infant mortality trends are especially troublesome. Since 2000, a half-century of sustained decline in infant death rates first slowed and then reversed. The infant mortality rate for the U.S. is now higher than for many other industrial countries. Malaysia – a country with one tenth of the U.S.’ average income – has achieved the same infant mortality rate. And the Indian state of Kerala has an infant death rate close to that of Washington D.C.