Does Health Insurance Coverage Mitigate or Exacerbate Socioeconomic Inequities in Health in the U.S.?

Amélie Quesnel-Vallée, McGill University

This paper examines the institutional impact of health insurance coverage on the pathways leading from status attainment to adult health. Using data from the 1979 National Longitudinal Survey of Youth, the analyzes consist of structural equation models of sibling resemblance (Hauser 1988). Results suggest that the cumulative effects of income are partially mediated by the effects of health insurance. More specifically, these analyzes indicate that health insurance and the source of coverage contribute to social inequities in health through very different pathways: first, the number of years privately insured was found to compound the positive sibling-specific effects of status attainment on health when contrasted with the lack of insurance; second, public insurance was not found to differ in its effects on health from private insurance; and third, public insurance may have the potential to reduce socioeconomic inequities from the family of origin when lack of insurance is the alternative.