OBJECTIVE. Young adults have the lowest rate of insurance coverage of any age group. Little is known about insurance patterns from adolescence through the early 30s. The objective of this study was to assess patterns and disparities in health insurance from adolescence through the early 30s.DESIGN. We analyzed data from the 2002 and 2003 National Health Interview Survey (ages 13–32; N = 48827). We examined public and private insurance coverage and conducted logistic regression to evaluate racial/ethnic and income disparities in coverage. Outcomes were insurance coverage at ages 13 to 32.RESULTS. Insurance patterns follow a U-shaped curve across the age categories. Rates are highest at ages 13 to 14, lowest at ages 23 to 24, and then increase gradually. Private rate patterns are similar; however, public coverage decreases across ages. In bivariate analyses, black and Hispanic groups had lower coverage rates than the white group, and the low- and middle-income groups had lower rates than the high-income group. After adjustment for confounding variables, all disparities remained significant except for differences between the black and white groups.CONCLUSIONS. After age 18, all groups are vulnerable to lack of insurance. Rate increases beyond age 25 to 26 years are attributable to increases in private coverage, whereas decreases in public coverage account for the lack of a full recovery to the higher rates seen in adolescence. The safety net of public programs that cover adolescents disappears in young adulthood, leaving young adults vulnerable, a problem that persists into the 30s for those who are in poverty and those who are of Hispanic origin.
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机译：目的。在所有年龄段中，年轻人的保险覆盖率最低。关于从青春期到30年代初期的保险模式知之甚少。这项研究的目的是评估从青春期到30年代初健康保险的模式和差异。我们分析了2002年和2003年全国健康访问调查（13-32岁; N = 48827）的数据。我们检查了公共和私人保险的承保范围，并进行了逻辑回归以评估种族/民族和承保范围内的收入差距。结果是保险年龄在13至32岁之间。保险模式在各个年龄段之间呈U形曲线。发病率在13至14岁最高，在23至24岁最低，然后逐渐增加。私人利率模式相似;但是，随着年龄的增长，公众的覆盖率会下降。在双变量分析中，黑人和西班牙裔人群的覆盖率低于白人，低收入和中等收入人群的覆盖率低于高收入人群。在对混杂变量进行调整之后，除黑人和白人之间的差异外，所有差异均保持显着性。结论。 18岁以后，所有群体都容易受到保险不足的困扰。 25至26岁以后的比率增加归因于私人保险的增加，而公共保险的减少则导致无法完全恢复到青春期的较高比率。覆盖青少年的公共计划的安全网在成年后就消失了，使成年后的年轻人变得脆弱，这个问题一直持续到30年代，对于那些处于贫困状态的人和来自西班牙裔的人来说。
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