Eastern Omaha, rural Nebraska have highest uninsured rates in state :Harold Reutter
By: Health Insurance
Submitted: 2009-09-25 15:25:30 | Word Count: 1168
In the Grand Island micropolitan area of Hall, Howard and Merrick counties, 14.7 percent of the population under the age of 65 has no health insurance.
That's a higher average than the state as a whole, which has 12.7 percent of its population under age 65 uninsured.
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Statistics on the percentage of uninsured residents in 2008 were released today by the U.S. Census Bureau as part of its American Community Survey.
Grand Island's micropolitan statistic (for areas with at least 65,000 residents) is in keeping with a statewide pattern in which the more rural portions have a higher percentage of uninsured residents than in the metropolitan areas.
The exception to that general rule includes portions of Omaha.
Nebraska's 12.7 percent uninsurance rate ranks 15th lowest in the nation.
In the United States as a whole, 17 percent of the population under 65 has no insurance.
The state with the highest percentage of uninsured residents under 65 was Texas at 26.5 percent, and the state with the lowest number of uninsured residents was Massachusetts at 4.6 percent.
Grand Island's three-county micropolitan area has 70,023 people, including 60,790 who are under age 65. Of those people, there are 8,952 residents without health insurance.
The Grand Island micropolitan area was just one of many areas in Nebraska measured by the U.S. Census Bureau. Douglas, Lancaster and Sarpy counties have their own separate measurements, as do the cities of Omaha and Lincoln.
Omaha's uninsurance rate was above the statewide average, with 15.6 percent of its under-65 population uninsured. Lincoln, with 10.9 percent uninsured, was much lower than the statewide average.
In addition to such recognized political subdivisions as counties and cities, the U.S. Census Bureau measured the percentage of uninsured in areas called Public Use Microdata Areas or PUMAs.
Each PUMA must have at least 100,000 people.
Douglas County was divided into four quadrants or PUMAs -- southeast, northeast, northwest and southwest. The center point for those quadrants is 72nd and Dodge in Omaha.
The southeast quadrant has an insurance rate of 21.5 percent for people under age 65, the northeast quadrant had 17.8 percent of its residents uninsured, with 9 percent uninsured in the northwest quadrant and 7.3 percent of the southwest quadrant uninsured.
David Drozd, research coordinator and census specialist for the Center for Public Affairs Research at the University of Nebraska at Omaha, said the higher level of uninsured residents in the southeast and northeast quadrants likely reflects "a higher unemployment rate because so much insurance is provided through employers."
With the exceptions of the southeast and northeast quadrants of Douglas County, the highest rates of uninsured residents live in rural Nebraska, a fact confirmed by statistics for the state's three congressional districts and by rural PUMAs.
The 1st Congressional District, which includes Lincoln, has 11.3 percent of its residents under 65 uninsured; the 2nd Congressional District, which includes Omaha, has 12.5 percent uninsured; and the 3rd Congressional District of greater Nebraska has 14.4 percent of its residents uninsured.
Drozd said the higher level of uninsured residents in rural Nebraska is probably due to three factors: the self-employed who cannot afford to insure themselves, those who work for smaller employers who cannot afford to offer insurance to their workers and those who choose to be uninsured.
Drozd said larger cities simply have more large employers who provide employee insurance as a benefit.
"A young farmer starting out may opt to go without insurance to control costs," Drozd said, explaining those who choose not to have insurance. But when that farmer gets older, he may well want health insurance.
Grand Island and Hall County belong to PUMA 300, an area that also includes Merrick, Hamilton, Howard, Greeley, Wheeler, Sherman, Valley, Garfield, Custer, Loup and Blaine counties. A total of 14.1 percent of the residents under age 65 in this 12-county area are uninsured.
PUMA 100, a 17-county area covering the north central and Panhandle areas of Nebraska, has 17.2 percent of its residents under age 65 who are uninsured, the highest percentage of any rural PUMA. Larger cities in this area include Scottsbluff, Chadron, Valentine and O'Neill. Boyd, Holt, Keya Paha, Rock, Brown, Cherry, Sheridan, Garden, Deuel, Cheyenne, Morrill, Box Butte, Dawes, Sioux, Scotts Bluff, Banner and Kimball counties are in Puma 100.
Puma 500, a nine-county area covering south Central Nebraska, had 14.6 percent of its population under 65 that was uninsured. Its larger cities include Kearney, Hastings and Holdrege. Counties in this area are Buffalo, Phelps. Kearney, Adams, Clay, Harlan, Franklin, Webster and Nuckolls.
Puma 400, which covers 18 counties in west Central Nebraska down to the Kansas border, has an uninsured rate of 15.4 percent of its population under age 65. Its larger communities include North Platte, Lexington and McCook.
Puma 200, a 16-county area in northeastern Nebraska that includes the cities of Norfolk, Columbus and South Sioux City has 14.5 percent of its population under 65 uninsured.
Census survey
This article focuses on the percentage of people under the age of 65 who are not insured.
When counting the number of uninsured, people who are under age 65 form an important category, because most people age 65 and over are covered by Medicare. That federal program gives the 65-and-over population a higher rate of insurance coverage than the population as a whole.
The Sept. 10 edition of The Independent reported on the number of people who were uninsured in Nebraska, according to the Current Population Survey. The CPS used only about 500 interviews to reach its conclusions.
The CPS showed that 11.9 percent of Nebraska's population was uninsured. However, charting the Current Population Survey over 10 years showed the number of uninsured Nebraskans had climbed significantly over that time.
The American Community Survey used a sample of 17,500 completed interviews to reach its conclusions. It showed a total of 12.7 percent of Nebraska's population under 65 had no insurance coverage.
David Drozd, research coordinator/U.S. Census specialist for the Center for Public Affairs Research at the University of Nebraska at Omaha, has written that means the American Community Survey should have much improved reliability and accuracy compared to the Current Population Survey.
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