Health Insurance and Healthcare among Older Construction Workers in the United States

Objectives: This study examined healthcare utilization among older construction workers in the U.S. and how health insurance affects healthcare utilization in workers' later years.

Methods: The 1992-2008 Health and Retirement Study (HRS), a nationally representative longitudinal survey of U.S. residents aged 50+ years, was analyzed. The initial survey conducted in 1992 contained 12,652 people born in 1931-1941 and were followed-up every two years. This study focused on 1,113 HRS respondents who were former or current construction workers, and examined their health, health insurance coverage, and healthcare utilization in 2008. Data analyses were conducted in SAS.

Results: About 23% of older construction workers aged 50-64 lacked health insurance in 2008 as opposed to less than 2% for those 65 or older. Insurance status directly affected workers' healthcare utilization in which 93% of older construction workers with insurance visited a doctor in the previous two years, compared with 75% among uninsured workers. More than 75% of insured workers reported taking prescription medications regularly, whereas only 45% of their uninsured counterparts did so. In addition, older workers who had public health insurance used more health services than those who had private health insurance. Furthermore, age, chronic conditions, and poor health significantly increased health service utilization.

Conclusions: Lack of health insurance is not uncommon among older construction workers before they are eligible for Medicare. This situation needs greater attention given the importance of health insurance to prevent disease and promote health in an aging workforce.