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BMJ. 2007 September 8; 335(7618): 471.
PMCID: PMC1971143

More uninsured Americans, less poverty, and more maternal deaths

The number of Americans who have no health insurance rose by 2.2 million last year to 47 million, up from 44.8 million in 2005, according to the US Census Bureau's annual update. Now 15.8% of the population is uninsured. More than 80% of them are employed but almost two thirds have low paid jobs.

The Census Bureau's report comes as Congress is about to discuss expanded health insurance coverage for children in the State Children's Health Insurance Program. Both houses of Congress passed bills to cover more uninsured children, who number almost nine million, but they need to reconcile differences in the bills. The president, George Bush, has proposed rules that would make it difficult for states to expand coverage. He has said that he will veto the bill because it draws children away from private health insurance coverage and encourages socialised medicine.

Almost 10% of Americans live in poverty, with the highest rate (28.3%) among households headed by a woman without a partner and in the southern states (13.8%). As defined by the Office of Management and Budget and updated for inflation using the Consumer Price Index, the weighted average poverty threshold in 2006 was $20 614 for a family of four; $16 079 for a family of three; $13 167 for a family of two; and $10 294 for unrelated individuals.

People getting health insurance as an employment benefit—the most common way—fell from 60.2% in 2005 to 59.7% in 2006. Because of the cost, fewer companies are offering health insurance and fewer employees are signing up even if their company offers insurance. A typical family plan now costs almost $11 500 a year—too much for many workers, according to the independent Kaiser Foundation.

Meanwhile, figures from the Centers for Disease Control and Prevention's National Center for Health Statistics show that, nationally, maternal deaths rose to 13 deaths per 100 000 live births in 2004, up from 12 deaths per 100 000 in 2003.

Black women are 3.7 times more likely than white women to die from causes related to child birth: the rate was 34.7 deaths per 100 000 live births among black women compared with 9.3 deaths among white women. The Washington Post newspaper reported that experts said that the high rate of caesarean sections (now 29% of births) and increased obesity leading to hypertension and diabetes, may play a role, as may the fact that more older women are giving birth (Washington Post, 24 Aug, “Experts: US childbirth deaths on rise”).

Notes

The Census Bureau's report is available at www.census.gov. The Centers for Disease Control and Prevention's report on maternal mortality is available at www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf.


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