People employed in farming, fishing, and forestry and construction and extraction – among the most hazardous occupations in the U.S. - have the highest prevalences of not having health insurance.

Rate of insured rose

That’s according to a new report from the CDC that sheds light on the number of employed people in the U.S. who lack health insurance – and on which types of workers are most affected. According to the report, during 2014, 12.7% of workers aged 18–64 years were uninsured (a 21% decline from 2013). Declines occurred in all demographic groups.

By occupational group, the 2014 prevalence of not having health insurance ranged from 37.0% (building and grounds cleaning and maintenance) to 2.7% (community and social services; and education, training, and library).

Study authors Winifred L. Boal, MPH1; Jia Li, MS1; Aaron Sussell, PhD2 note that lack of health insurance has been associated with poorer health status and with difficulties accessing preventive health services and obtaining medical care, especially for chronic diseases.

What are the implications for public health practice?

Identifying factors affecting differences in insurance rates by occupation might help to target interventions to reduce health disparities among U.S. workers.

In both 2013 and 2014, a lower percentage of workers were uninsured in the 12 states that expanded Medicaid eligibility than were in the five states that did not, and the prevalence of being uninsured declined more (23%) in states that expanded Medicaid than in those that did not (9%; p = 0.013), although the percentage point difference between the two groups of states was not statistically significant.

Click here to read detailed study results.