Sources of health insurance and characteristics of the uninsured: analysis of the March 2001 Current Population Survey

This Issue Brief provides summary data on the insured and uninsured populations in the nation and in each state. It discusses the characteristics most closely related to an individual's health insurance status. Based on EBRI estimates from the March 2001 Current Population Survey (CPS), it represents 2000 data--the most recent available. Between 1999 and 2000, the percentage of Americans with health insurance increased: 84.1 percent of nonelderly Americans were covered by some form of health insurance in 2000, up from 83.8 percent in 1999. The percentage of nonelderly Americans without health insurance coverage declined from 16.2 percent in 1999 to 15.9 percent in 2000, continuing a trend that started between 1998 and 1999. The main reason for the decline in the number of uninsured Americans was the strong economy and low unemployment. Between 1999 and 2000, the percentage of nonelderly Americans covered by employment-based health insurance increased from 66.6 percent to 67.3 percent, continuing a longer-term trend that started between 1993 and 1994. In 2000, 34.3 million Americans received health insurance from public programs, and an additional 16.1 million purchased it directly from an insurer. More than 25 million Americans participated in Medicaid or the State Children's Health Insurance Program, and 6.1 million received their health insurance through the Tricare and CHAMPVA programs and other government programs designed to provide coverage for retired military members and their families. Even though the number and percentage of uninsured declined substantially between 1998 and 2000, more than 38 million Americans remain uninsured. While an increasing percentage of Americans were being covered by employment-based health plans, this trend may not continue because of the combined re-emergence of health care cost inflation and the weak economy. As long as the economy is strong and unemployment is low, employment-based health insurance coverage will expand and the uninsured will decline gradually. However, the combination of the current weak economy and the rising cost of providing health benefits will likely result in more Americans without health insurance coverage. Should the uninsured remain unchanged and continue to represent 15.9 percent of the nonelderly population, 40 million would be uninsured by 2005. If the uninsured represented 25 percent of the population, 63 million would be uninsured in 2005 and 65 million nonelderly Americans would be uninsured by 2010.     

Health professional students' occupational exposures to blood-borne pathogens: primary and secondary prevention strategies

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

Human resource issues in university health services

To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.     

Long-term care funding in Canada: a policy mosaic

When Canada was founded, health care was delegated as a provincial responsibility. Although the federal government shares a portion of health care costs, it is not directly responsible for the planning, delivery, and governance of health services. The 1984 Canada Health Act set national standards for the provision of physician and hospital services, but it does not apply to home care and long-term care facilities. Consequently, each province has established a unique approach to long-term care, resulting in a health policy mosaic. This paper examines different approaches to funding long-term care with a particular emphasis on the impacts of regionalization and of the implementation of case-mix-based funding systems.     

Brief group alcohol interventions with college students: examining motivational components

The utility of brief interventions with at-risk college drinkers would be enhanced if they could also be delivered in group settings without the need for risk prescreening. The current study therefore explored whether components of brief interventions could be effectively administered to mixed groups of drinking and non-drinking students. Specifically, the outcomes of two methods aimed toward increasing motivation for change were compared to controls. One intervention focused on enhancing actual-ideal drinking behavior discrepancy through a structured group discussion, while the other focused on enhancing self-norm drinking behavior discrepancy through the provision and discussion of didactic information. Among at-risk drinkers, significant reductions in heavy drinking episode frequency at four-week follow-up were found for the self-norm (S-N) group only, while reductions in alcohol problems were obtained in both the S-N and control groups. Results suggest that self-norm discrepancy enhancement strategies may be more effective than actual-ideal discrepancy strategies when used with a mixed drinking group.     

Differences in African American and White college students' drinking behaviors: consequences, harm reduction strategies, and health information sources

The authors explored the differences between African American and White college students' drinking behaviors and their attitudes toward consequences, harm-reduction strategies, and health information sources. They collected data from a randomly selected sample of 1,110 students in a large public university to examine the effects of a high-risk drinking prevention intervention. In the current analysis, they compared African American and White students on indicators of high-risk drinking, drinking consequences, harm-reduction strategies, the sources that students typically used for health information, and the believability of those sources. The African American students scored lower on drinking measures than the White students did, reported fewer negative consequences, and more regularly employed drinking-reduction strategies, with one exception--choosing a designated driver. Both African and White respondents reported that their parents were their most frequent and usual sources of health-related information and said that parents and health professionals were the most credible sources.     

Treatment of incarcerated, sexually-abused adolescent females: an outcome study

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.     

The effects of a continuous passive motion device on myoelectric activity of the erector spinae during prolonged sitting at a computer workstation

Continuous passive motion (CPM) has been proposed as a method to help individuals with low back pain cope with prolonged sitting. The purpose of this study was to investigate the effects that a commercially available CPM device had on lumbar and thoracic erector spinae (ES) muscle activation (using surface electromyography, "EMG"), and on subjective discomfort during prolonged seated computer work with and without the use of the CPM device. There were no significant differences in average ES muscle activation levels, amplitude probability distribution functions, and EMG gaps number and length when sitting with the CPM device was compared to sitting normally. Subjective ratings of discomfort were also not significantly different between the two sitting conditions. The results indicated that there were no clear mechanisms by which the CPM device may reduce ES muscle pain and fatigue for the tasks and pain-free individuals studied.