abstract: 'Objective To add to the evidence base on causal linkages between health

  insurance coverage and health status, controlling for sociodemographic

  factors, by analyzing longitudinal data. Data Source Secondary data from

  the Panel Study of Income Dynamics (PSID), 2009-17, which is a

  longitudinal, multigenerational study covering a wide array of

  socioeconomic topics that began in 1968 but has only recently begun

  collecting useful information on individual health insurance. Study

  Design 2017 data on self-reported health status, work limitations, and

  death were analyzed as outcomes based upon the degree of exposure to

  health insurance in 2011-17. All variables were collected biannually for

  four years beginning in 2011. Having health insurance at each point in

  time was, in turn, modeled as a function of several sociodemographic

  factors. Data Extraction Methods Data were downloaded using the

  crosswalk tool available at the PSID website. Because individual health

  insurance questions were only asked of heads and spouses in households

  beginning in 2011, we analyzed only these records. Principal Findings

  Among respondents who were not in fair or poor health in 2009, each

  additional 2 years of subsequent reported insurance coverage reduced the

  chance of reporting fair or poor health in 2017 by 10 percent; however,

  this effect was not present for black respondents. Conclusions Our

  results suggest that the effect of health insurance on health status may

  compound over time, although unevenly by race. Since people who report

  fair or poor health status represent the bulk of utilization and

  spending, our findings provide evidence in support of viewing coverage

  expansions as investments that will pay dividends in the form of lower

  utilization over time. More work is needed to produce detailed estimates

  of cost savings, which may in turn influence policy, as well as to

  understand and address the source of racial disparity.'
affiliation: 'Barker, AR (Corresponding Author), Washington Univ St Louis, Brown Sch,
  1 Brookings Dr,Campus Box 1196, St Louis, MO 63130 USA.

  Barker, Abigail R.; Li, Linda, Washington Univ St Louis, Brown Sch, 1 Brookings
  Dr,Campus Box 1196, St Louis, MO 63130 USA.'
author: Barker, Abigail R. and Li, Linda
author-email: arbarker@wustl.edu
author_list:
- family: Barker
  given: Abigail R.
- family: Li
  given: Linda
da: '2023-09-28'
doi: 10.1111/1475-6773.13325
earlyaccessdate: JUL 2020
eissn: 1475-6773
files: []
issn: 0017-9124
journal: HEALTH SERVICES RESEARCH
keywords: 'health care costs; health insurance; health status; Medicaid; Medicare;

  race factors'
keywords-plus: MEDICAID; ADULTS
language: English
month: OCT
number: 2, SI
number-of-cited-references: '21'
orcid-numbers: 'Li, Linda/0000-0003-0996-7763

  Barker, Abigail/0000-0002-0826-5156'
pages: 815-822
papis_id: 3cdc78abbfeefbff61d01dc317411728
ref: Barker2020cumulativeimpact
times-cited: '9'
title: The cumulative impact of health insurance on health status
type: article
unique-id: WOS:000551061100001
usage-count-last-180-days: '0'
usage-count-since-2013: '12'
volume: '55'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2020'