Does medical insurance contribute to socioeconomic differentials in health?

Both access to insurance and health itself vary widely by socioeconomic sta tus (SES). Are socioeconomic variations in health linked to insurance cover age or to factors that lie outside the medical care arena? Data from the Ag ing, Status, and the Sense of Control Survey were the basis of a representa tive U.S. national telephone survey conducted in 1995, and again in 1998. t he results showed that persons with private insurance do nor differ signifi cantly from the uninsured in their self-reported health, physical functioni ng, or number of chronic conditions, whereas persons with public insurance report significantly worse health and more chronic conditions than the unin sured. These longitudinal results hold with adjustment for baseline health, SES, change in social status, and the hazard of attrition. Medical insuran ce does not mediate any associations between SES and health. Medical insura nce of all kinds, however, does reduce difficulties in paying medical bills , and Medicaid is associated with more doctor visits and prescription drugs .