(HealthDay News) – Being underinsured correlates with increased mortality after acute cardiovascular events, while race is not associated with increased mortality, according to a study published online July 21 in the Journal of General Internal Medicine.
Derek K. Ng, ScM, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, and colleagues examined the relative risk of death associated with insurance and race in a cohort of 4,908 patients with acute myocardial infarction, 6,759 with coronary atherosclerosis, and 1,293 with stroke; all were admitted to 3 hospitals with unique demographics in Maryland between 1993 and 2007.
The researchers found that being underinsured correlated with an increased risk of death after myocardial infarction (relative hazard, 1.31), coronary atherosclerosis (relative hazard, 1.50), or stroke (relative hazard, 1.25; 95% confidence interval [CI], 0.91–1.72), after adjustment for race, disease severity, location, neighborhood socioeconomic status, and other factors. Among blacks, there was no increased risk of death after myocardial infarction (relative hazard, 1.03; 95% CI, 0.85–1.24) or after stroke (relative hazard, 1.18; 95% CI, 0.86–1.61). Black race was associated with a significantly decreased risk of death after coronary atherosclerosis (relative hazard, 0.82).
“Our results support growing evidence implicating insurance status and socioeconomic factors as important drivers of health disparities, and potentially racial disparities,” the authors write.