U S C E N S U S B U R E A U

Helping You Make Informed Decisions

U.S. Department of Commerce

Economics and Statistics Administration

U.S. CENSUS BUREAU

Dynamics of Economic Well-Being:

Health Insurance 1996-1999

Household Economic Studies

P70-92

Issued August 2003

Current

Population

Reports

By 

Shailesh Bhandari 

and 

Robert Mills

Demographic Programs

INTRODUCTION • Women’s higher coverage rates were

due to government health insurance, This report uses longitudinal data from which covered 11.6 percent of men the 1996 panel of the Survey of Income and 15.3 percent of women in all and Program Participation (SIPP) to exam- 48 months. Private health insurance ine the health insurance coverage of peo- rates (57.9 percent for men and ple from 1996 to 1999. During the 57.7 percent for women for all 48-month survey period, respondents months) were equal. reported their health insurance status for

each month, providing the opportunity • Although not all year-to-year changes

to observe how long people are covered were significant, the health insurance

by health insurance or how long they go coverage rate was higher in 1999 than

without coverage. in 1996. The percentage of people covered throughout the calendar year was This report focuses on the dynamics of 78.2 percent in 1996 and 80.4 percent health insurance coverage and how pat- in 1999. terns vary across economic and demographic groups. The number of months • The gender gap in health insurance

without health insurance varied for dif- coverage rates did not change from

ferent groups, 96.7 percent of all people 1996 to 1999. In 1996, the women’s

were covered for at least 1 month of the entire-year coverage rate was higher

48-month study period and 32.1 percent than that of men by 3.0 percentage

lacked health insurance at least 1 points (79.6 percent compared with

month.1

76.6 percent), not different from the

gaps in successive years of the panel.

HIGHLIGHTS

• Hispanics (of any race) were the most • Women were more likely than men to likely and non-Hispanic Whites were have health insurance for a longer the least likely to be without health period of time. About 4.0 (± .3) per- insurance.2 In 1999, 14.6 percent of cent of men and 2.7 percent of non-Hispanic Whites, 28.8 percent of women were without health insurance Blacks, and 40.6 percent of Hispanics for the entire 48-month reference peri- experienced at least 1 month of no od, and 66.7 percent of men and coverage. 69.0 percent of women were covered

in all 48 months.

2

1 Because Hispanics may be of any race, data in The estimates in this report are based on this report for Hispanics overlap slightly with data for responses from a sample of the population. As with the Black population. Based on data in the 1996 SIPP all surveys, estimates may vary from the actual val- panel and using the panel weight, 3.5 percent of the ues because of sampling variation or other factors. Black population was of Hispanic origin. Data for All comparisons made in this report have undergone Asians and Pacific Islanders and American Indians statistical testing, and all comparisons are significant and Alaskan Natives are not shown in this report at the 90-percent confidence level unless otherwise because of their small sample sizes. noted.
• Compared with other age groups,

people aged 18 to 24 were the

least likely to have health insurance — only 62.0 percent were

insured all 12 months in 1999.

As the teenagers became adults,

health insurance coverage rates

decreased. An estimated 9.1 percent of 17-year-olds lacked health

insurance for all of 1996, but the

rate for the same cohort

increased to 15.4 percent at age

20 in 1999. 

• During the 48-month period,

people in the Northeast and the

Midwest had the highest probability of continuous coverage at

just over 73 percent. People in

the Northeast were also the

most likely to have continuous

government health insurance.

• Suburban residents were the

most likely to have continuous

health insurance coverage 

(72.6 percent) followed by people living outside metropolitan

areas (64.7 percent) and those

who lived in central cities 

(62.2 percent).

• Health insurance coverage rates

rose with educational level. In

1999, only 3.0 percent of college graduates were without

health insurance for the entire

year; this was lower than the

rates for people with some college (7.1 percent), high school

graduates (8.7 percent), and

people who did not complete

high school (15.5 percent). 

• People not in the labor force

were more likely than those in

the labor force (employed and

unemployed) to have continuous

health insurance coverage; and,

among those in the labor force,

full-time employed people were

the most likely to have so.3 In

1996, 83.7 percent of people not

in the labor force reported continuous coverage, higher than

the corresponding rates for fulltime employed (81.7 percent),

part-time employed (70.5 percent), and unemployed (38.5 percent) people.

• Marriage also lowered the risk of

being without health insurance.

About 20.7 percent of currently

married people reported at least

1 month of no health insurance

during 48 months. Comparable

rates were higher for previously

married people (28.6 percent)

and never-married people 

(44.6 percent).

• Among all people with at least

one spell of no health insurance

2 U.S. Census Bureau

3 Those not in the labor force include the

retired population and others not looking for

a job.

Figure 1.

Number of Months of Health Insurance Coverage 

by Sex: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent)

All people

0 to 47 48 months

months

0 to 36

months

0 to 24

months

0 to 12

months

No months

Men

0 to 47 48 months

months

0 to 36

months

0 to 24

months

0 to 12

months

No months

Women

0 to 47 48 months

months

0 to 36

months

0 to 24

months

0 to 12

months

No months

3.3 6.9 11.1

17.9

32.1

67.9

4.0 7.8 12.3

19.2

33.3

66.7

2.7 6.0 10.0

16.7

31.0

69.0
coverage over the 48-month period, the median spell without

health insurance was 5.6

months. People experiencing

median spells without health

insurance coverage longer than

others included people not completing high school (8.8 months),

unemployed people (8.7

months), Hispanics (8.3 months),

and previously married people

(8.1 months).

HEALTH INSURANCE

COVERAGE RATES: 1996 -

1999

About two-thirds of all people

(67.9 percent) had some kind of

health insurance for the entire 48-

month period and only 3.3 percent

had no health insurance coverage

the whole period.4

Women were more likely than

men to have continuous

coverage.

Women were more likely then men

to be covered by health insurance

for at least 1 month in the 48-

month period, and women were

also more likely to report continuous coverage. About 97.3 percent

of women and 96.0 percent of men

were covered by health insurance

for at least a month. Continuous

coverage was reported by 

69.0 percent of women and 

66.7 percent of men (see Figure 1). 

This difference largely reflects higher coverage from government

health insurance for women 

(15.3 percent of women and 

11.6 percent of men received government health insurance for the

entire 48 months). Men and women

reported similar private coverage

for the same period (57.9 percent

of women and 57.7 percent of

men).

ANNUAL HEALTH

INSURANCE RATES

Coverage rates improved

every year from 1996 to 1999.

Health insurance coverage rates

increased over the years (see Figure

3).5 Although not all year-to-year

changes were significant, the health

insurance coverage rate was higher

in 1999 than in 1996.6 For example,

8.8 percent of all people lacked

health insurance for the entire year

in 1996, decreasing to 8.0 percent

in 1999. About 14.3 percent of all

people were covered for no more

than 6 months in 1996, decreasing

to 12.8 percent in 1999. The percentage of people covered throughout the calendar year was 78.2 percent in 1996, and 80.4 percent 

in 1999.

A gender gap in health

insurance coverage did not

change during the panel years.

The entire-year coverage rate was

higher for women than for men by

3.0 percentage points in 1996 (79.6

compared with 76.6 percent), which

was not different from the gap of

2.6 percentage points in 1997 and

U.S. Census Bureau 3

4 These rates are based on the observed

48-month reference period with no regard to

left- and right-censored spells. Survival

analysis later in the report will take account

of the censored spells.

5 As in all longitudinal surveys, year-toyear changes in the SIPP health insurance

rates may in part reflect selection bias due

to sample loss. 6 The entire year coverage rates in 1996

and 1997 were not statistically different.

Figure 2.

Private and Government Health Insurance Coverage 

Rates Among Men and Women: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent)

Private health insurance

0 to 47 48 months

months

0 to 36

months

0 to 24

months

0 to 12

months

No months

0 to 47 48 months

months

0 to 36

months

0 to 24

months

0 to 12

months

No months

Government health insurance

Men

Women

10.7

17.5 22.7

29.3

42.4

57.7

9.3

16.5 22.0

28.8

42.1

57.9

66.7 73.6 77.4 80.7 84.7

15.3

74.1

79.6 82.6 85.2 88.4

11.6
2.1 percentage points in both 1998 Hispanics were the least likely than 12 months of coverage, the

and 1999. However, a gap in 0-to-6 to have continuous coverage. comparable rate for Hispanics was

month coverage rates between men 40.6 percent. The likelihood of no Among the race-ethnicity groups,

and women narrowed from 3.0 per- coverage for the entire year was non-Hispanic Whites were the most

centage points (15.8 percent com- also highest among Hispanics. In likely and Hispanics were the least

pared with 12.8 percent) in 1996 to 1999, 21.1 percent of Hispanics, likely to have continuous coverage

2.1 percentage points in 1999 10.9 percent of Blacks, and every year during the survey peri-

(13.9 percent compared with 5.5 percent of non-Hispanic Whites od. In 1999, while 14.6 percent of

11.8 percent). lacked health insurance for the non-Hispanic Whites and 28.8 perentire year (see Figure 3). cent of Blacks experienced less

4 U.S. Census Bureau

Figure 3.

Annual Health Insurance Rates: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent)

Always covered

All Men Women Non-Hispanic Whites Blacks Hispanics (any race)

All Men Women Non-Hispanic Whites Blacks Hispanics (any race)

Covered 6 months or less

All Men Women Non-Hispanic Whites Blacks Hispanics (any race)

Never covered

1996

1997

1998

1999

80.4 79.3 81.4 85.4

71.2

59.4

79.5 78.4 80.5 84.8

70.4

56.5

78.4 77.1 79.7 83.8

69.0

55.2

78.2 76.6 79.6 83.4

68.4

55.4

12.8 13.9 11.8 9.1

18.1

30.5

13.1 14.3 11.9 9.1

18.5

32.1

13.7 15.0 12.5 9.8

18.9

32.4

14.3 15.8 12.8 10.5

19.7

33.0

8.0 9.0 7.2 5.5 10.9

21.1

8.0 9.1 6.9 5.4 10.2

21.9

8.3 9.4 7.2 5.8 10.5

21.9

8.8 10.1 7.6 6.4 11.4

22.2
People aged 18 to 24 were the

least likely to be insured of

all age groups.7

People aged 55 to 64 were the

most likely and those aged 18 to 24

were the least likely to have entireyear coverage.8 In 1999, while 

90.8 percent of people aged 55 to

64 reported entire-year coverage,

only 62.0 percent of those aged 18

to 24 did so. Additionally, people

aged 55 to 64 were the least likely

and those aged 18 to 24 were the

most likely to have zero months of

coverage.9 In 1999, while 4.9 percent of people aged 55 to 64 had

no coverage in any month in the

year, the comparable figure for

those aged 18 to 24 was 14.5 percent (see Figure 4).

COVERAGE RATES 

BY REGION AND

METROPOLITAN AREA

The Midwest had the highest

private and one of the lowest

government health insurance

coverage rates.

During the 48-month period, the

Northeast and the Midwest had the

highest probability of continuous

coverage at 73.2 percent and 

73.4 percent, respectively.10

However, the private health insurance rates and government health

insurance rates in these regions

differed. People in the Midwest

were the least likely to have continuous government health insurance and the most likely to have

continuous private health insurance.11 On the other hand, people

in the Northeast were the most

likely to have continuous government health insurance.

The South and West had similar

private health insurance rates

(52.8 and 53.1, respectively) and

U.S. Census Bureau 5

7 People aged 65 or over have been omitted from this analysis as they generally have

medicare coverage (93.0 percent for the

entire year in 1999); 98.6 percent of people

aged 65 or over had health insurance coverage for the entire year in 1999. 8 The entire year coverage rates were not

statistically different between people aged

45 to 54 and 55 to 64 in 1996, and between

people aged 18 or less and 25 to 34 in

1997.

9 The zero-month coverage rates were

not statistically different for people aged 17

or less, 45 to 54, and 55 to 64 in both 1996

and 1997; between people aged 17 or less

and 45 to 54 in 1998; and between people

aged 17 or less and 35 to 44 in 1999.

10 These rates are not statistically different.11 Government health insurance rates in

the Midwest and in the West were not statistically different.

Figure 4.

Health Insurance Coverage Rates by Age: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent)

Always covered

17 or less 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64

17 or less 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64

Never covered

1996

1997

1998

1999

74.2

62.0

77.9

83.5 87.4 90.8

73.7

58.9

75.4

82.7 86.8 88.6

73.1

57.8

73.1

80.6 85.1 87.2

75.0

58.0

70.5

79.5 84.1 85.4

8.4

14.5 10.5 8.6 7.2 4.9 7.8

15.1

7.6 11.0 8.9 7.0 5.3

15.7 11.5 7.4 9.4 7.3 6.8

16.8 12.8 10.1 7.8 7.7
government health insurance rates

(13.6 and 12.9, respectively).12

Their overall health insurance rates

were also equal. 

People in suburbs had the

highest coverage rates among

geographic areas.13

People in suburbs reported the

highest continuous health insurance

coverage (72.6 percent) followed by

people outside metropolitan areas

(64.7 percent). People in central

cities reported the lowest rate at

62.2 percent. In terms of private

health insurance coverage rates,

those in the suburbs reported the

highest at 64.3 percent and those in

central cities reported the lowest at

50.0 percent. Regarding government health insurance, 12.1 percent

of the suburban population was

6 U.S. Census Bureau

12 Both comparisons are not statistically

different.

13 In this report, “suburbs” refers to metropolitan areas outside central cities.

Figure 5.

Number of Months of Health Insurance Coverage by Region: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent)

Any health insurance

0 months 0 to 12 months 0 to 24 months 0 to 36 months 0 to 47 months 48 months

0 months 0 to 12 months 0 to 24 months 0 to 36 months 0 to 47 months 48 months

Private health insurance

0 months 0 to 12 months 0 to 24 months 0 to 36 months 0 to 47 months 48 months

Government health insurance

Northeast

Midwest

South

West

4.1 8.4

13.1

20.7

35.8

64.2

4.6 9.4

14.8

22.6

36.7

63.3

1.7 3.7 6.9

12.5

26.6

73.4

2.3 4.8 8.0

13.4

26.8

73.2

69.2

75.8 79.6 82.8 87.1

12.9

69.6

76.5 80.0 83.1 86.5

13.6

73.2 78.7 81.9 84.4 87.5

12.5

69.0 74.5 77.6 80.5 84.5

15.5

12.4

20.8

26.7

33.4

46.9

53.1

12.5

20.4

26.6

33.9

47.2

52.8

6.3 10.8

14.9

21.2

34.3

65.8

7.8

14.6

19.3

25.6

38.2

61.8
continuously covered by this

source, the lowest among all areas

of residence. People living outside

metropolitan areas were the most

likely to have continuous government health insurance at 16.1 percent.

HEALTH INSURANCE RATES

BY EDUCATION AND JOB

MARKET STATUS14 

As education level increased,

so did the health insurance

coverage rates.

People who had not completed

high school were the most likely to

be without coverage — 15.5 percent did not have health insurance

for the entire 1999. The corresponding rates were lower for high

school graduates (8.7 percent),

those with some college but no

degree (7.1 percent), and college

graduates (3.0 percent). College

U.S. Census Bureau 7

14 The education level and the labor market

status are as of the first month of the corresponding year. Only people aged 25 or over

(education) or aged 18 or over (work) have

been included in the analysis.

Figure 6.

Number of Months of Health Insurance Coverage 

by Residence: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent)

Any health insurance

0 months 0 to 12 months 0 to 24 months 0 to 36 months 0 to 47 months 48 months

0 months 0 to 12 months 0 to 24 months 0 to 36 months 0 to 47 months 48 months

Private health insurance

0 months 0 to 12 months 0 to 24 months 0 to 36 months 0 to 47 months 48 months

Government health insurance

Inside metropolitan 

Central city 

Suburbs 

Outside metropolitan

4.0 7.9 12.9

20.7

35.3

64.7

2.6 5.5 9.2

14.6

27.4

72.6

4.1 8.5 13.2

21.5

37.9

62.2

3.1 6.6 10.7

17.2

31.2

68.8

12.6

20.3

26.3

33.4

46.8

53.2

7.0

12.4 17.0

22.6

35.8

64.3

13.4

22.6

28.6

37.0

50.0 50.0

9.3

16.1

21.3

27.9

41.0

59.0

64.7

71.9 75.9 79.7 83.9

16.1

75.1

80.4 83.0 85.3 87.9

12.1

66.0

73.1 77.5 81.1 85.9

14.1

71.8

77.7 81.0 83.7 87.2

12.8
Figure 7.

Number of Months Covered in a Year by the Level of 

Education: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent. People aged 25 or over)

Less than high school

0 months 1 to 6 months 7 to 11 months 12 months

0 months 1 to 6 months 7 to 11 months 12 months

0 months 1 to 6 months 7 to 11 months 12 months

0 months 1 to 6 months 7 to 11 months 12 months

High school graduates

Some college, no degree

College graduates

1996

1997

1998

1999

15.5

5.0 5.0

74.5

14.9

5.5 5.8

73.9

14.4

5.9 5.6

74.2

14.9

5.7 6.3

73.1

8.7 3.9 5.2

82.2

8.7 4.0 5.4

82.0

9.1 4.6 5.4

80.8

9.7 4.7 5.8

79.8

7.1 3.8 4.6

84.4

6.8 3.8 5.0

84.4

7.1 4.4 6.0

82.6

7.3 4.6 5.5

82.6

3.0 1.8 3.1

92.1

3.3 2.1 3.8

90.9

3.6 2.4 3.9

90.1

3.8 2.7 3.7

89.8

8 U.S. Census Bureau
Figure 8.

Number of Months Covered in a Year by Job Market Status: 

1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

(In percent. People aged 18 or over)

Full-time employed

0 months 1 to 6 months 7 to 11 months 12 months

0 months 1 to 6 months 7 to 11 months 12 months

0 months 1 to 6 months 7 to 11 months 12 months

0 months 1 to 6 months 7 to 11 months 12 months

Part-time employed

Unemployed

Not in the labor force

1996

1997

1998

1999

7.1 3.7 5.1

84.1

7.2 4.0 5.7

83.1

7.4 4.3 6.1

82.3

8.0 4.5 5.8

81.7

12.6 6.5 7.4

73.5

12.6 6.9 8.5

72.0

13.6 7.7 9.0

69.7

13.3 8.0 8.3

70.5

30.4

17.5 13.8

38.4

31.5

15.7 12.8

40.1

29.0

18.7 13.1

39.2

30.8

15.2 15.4

38.5

7.4 3.4 4.2

85.0

6.9 3.7 4.8

84.6

6.7 3.7 4.6

85.0

7.5 3.9 4.9

83.7

U.S. Census Bureau 9
graduates were the most likely to

have health insurance coverage

(see Figure 7).

People not in the labor force

had the best chance of

coverage.

Since the SIPP collects the job status information for each week, it is

possible to isolate people who are

not in the labor force from those

who are in the labor force. Those

in the labor force include

employed and unemployed people,

and those not in the labor force

include the retired population and

other nonworkers who are not

looking for a job. People not in the

labor force were the most likely to

have continuous health insurance

coverage — an estimated 83.7 percent in 1996 — mainly because

this group includes people aged 65

and over, mostly covered by

medicare. 

Among those who are in the labor

force, full-time employed people

reported the highest entire year

coverage rate (81.7 percent in

1996) followed by part-time

employed (70.5 percent) and

unemployed (38.5 percent) people. 

An estimated 30.4 percent of

unemployed people were without

health insurance for the entire year

in 1999, the highest rate among

job market groups. The corresponding rates of zero months of coverage were 12.6 percent, 7.1 percent, and 7.4 percent for part-time

employed, full-time employed, and

those not in the labor force,

respectively.15

HEALTH INSURANCE

STATUS AS CHILDREN

GROW UP

Children lose health insurance

as they grow up.

Compared with people aged 17, the

uninsured rates were successively

higher for those aged 18, 19, and

20 in each year of the panel except

1997.16 When following each of

these cohorts over time, their uninsured rates also rose each year they

aged.17 Among 17-year-olds in

1996, 9.1 percent were without

health insurance for the entire year,

but the rate for the same cohort

increased to 10.1 percent in 1997,

11.9 percent in 1998, and 15.4 percent in 1999.18

LOSING AND REGAINING

HEALTH INSURANCE

About 1 in 3 people were

without health insurance for

at least 1 month.

While 67.9 percent of all people

had health insurance coverage for

the entire 48 months, the remaining 32.1 percent had at least 1

month of no coverage. An analysis

of various groups indicates that

unemployed people were the most

likely and people aged 65 or over

were the least likely to experience

at least 1 month of no coverage.

At 20.7 percent, currently married

people were less likely to experience no coverage than most of all

other groups — only two groups

had lower uninsured rates: those

aged 65 or over (2.3 percent) and

those with a college degree 

(15.5 percent) (see Figure 10).19

Median spell duration without

health insurance was 5.6

months.

Some people regained health insurance sooner than others after losing it. While some people had only

10 U.S. Census Bureau

15 The zero-month coverage rates for fulltime employed and those not in the labor

force were not statistically different in 1996,

1998, and 1999.

16 The uninsured rates were not statistically different between people aged 18 and

19 in 1996 and 1998, between 17 and 18 in

1997, and between 19 and 20 in 1999; and,

in 1997, people aged 19 were more likely

than those aged 20 to be without health

insurance. However, a comparison of 4-year

averages shows a higher coverage rate at

age 17 than at 18, 19, or 20. 17 The uninsured rates for the cohort of

18-year olds in 1996 did not differ as they

turned 19 in 1997 and 20 in 1998. Ages

shown are as of the first month of the year. 18 Data tabulation by single year of age

produces estimates based on small sample

sizes. Thus, these estimates have relatively

large standard errors. Readers should therefore use caution while interpreting estimates

based on small sample sizes.

19 The uninsured rate for currently married people was not different from the rate

for people aged 55 to 64.

Figure 9.

Percentage of Teenage People Without 

Health Insurance: 1996 - 1999 

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

Never covered

1996 1997 1998 1999

Age 17

Age 18

Age 19

Age 20

17.8 14.0 14.4 12.9 14.4 15.4 11.9 13.6 15.2 10.1 12.5 11.4 9.1 10.4 8.3 9.2
Figure 10.

Percent With at Least 1 Month With No Health Insurance in the 

48-Month Period: 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

Not in labor force

Unemployed

Employed part-time

Employed full-time

Outside metro

Metro area

Suburbs

Central cities

West

South

Midwest

Northeast

Nonpoor

Poor

College degree

Some college

High school degree

No high school degree

Never married

Previously married

Currently married

Age 65 or more

Age 55 to 64

Age 45 to 54

Age 35 to 44

Age 25 to 34

Age 18 to 24

Age 17 or less

Hispanics (any race)

Blacks

Non-Hispanic Whites

Women

Men

All people

23.5

32.1

33.3

31.0

25.9

46.7

56.3

40.4

62.5

39.0

27.5

22.2

19.4

2.3

20.7

28.6

44.6

34.8

27.6

24.4

15.5

63.5

26.2

26.8

26.6

36.7

35.8

37.8

27.4

31.2

35.3

26.3

40.0

71.6

U.S. Census Bureau 11
Figure 11.

Median Number of Months Without Health Insurance During 1996 - 1999

Source: U.S. Census Bureau, 1996 Survey of Income and Program Participation.

Not in labor force

Unemployed

Employed part-time

Employed full-time

Outside metro

Metro area

Suburbs

Central cities

West

South

Midwest

Northeast

Nonpoor

Poor

Never married

Previously married

Currently married

College degree

Some college

High school degree

No high school degree

Age 65 or more

Age 55 to 64

Age 45 to 54

Age 35 to 44

Age 25 to 34

Age 18 to 24

Age 17 or less

Hispanics (any race)

Blacks

Non-Hispanic Whites

Women

Men

All people

7.53

5.56

5.58

5.54

4.97

5.92

8.33

4.89

7.18

6.77

7.63

7.81

6.18

4.68

8.78

7.16

6.44

4.91

6.06

8.06

4.99

6.63

5.14

5.60

5.48

5.53

5.63

5.34

4.92

7.17

5.13

6.50

6.60

8.73

12 U.S. Census Bureau
U.S. Census Bureau 13

one spell of no health insurance,

others had more spells. The median spell duration without health

insurance was 5.6 months for all

people who experienced at least

one spell of no health insurance,

excluding spells underway during

the first month of the SIPP survey

(see Figure 11).20

The median spell of no health insurance was highest among people

who did not complete high school

(8.8 months), followed by unemployed people (8.7 months),

Hispanics of any race (8.3 months),

and previously married people (8.1

months). The shortest median spell

was experienced by people aged 65

or over (4.7 months), followed by

people aged 17 or less (4.9

months), people with a college

degree (4.9 months), people in the

Midwest (4.9 months), non-Hispanic

Whites (5.0 months), and never

married people (5.0 months).21

SOURCE OF THE DATA

The population represented (the

population universe) in the 1996

Survey of Income and Program

Participation (SIPP) is the civilian

noninstitutionalized population of

the United States. The SIPP is conducted at 4-month intervals. The

data in this report refer to the period from January 1996 through

December 1999. The institutionalized population, which is excluded

from the population universe, is

composed primarily of the population in correctional institutions and

20 Left censored spells have been omitted

and the right censored spell lengths are estimated by using life table methods. 21 The median spell estimation is sensitive to the technique used and the interval

chosen. The estimates in Figure 11 are

based on life table techniques and use a 1-

month interval. 

nursing homes (91 percent of the

4.1 million institutionalized population in Census 2000).

ACCURACY OF THE

ESTIMATES

Statistics from surveys are subject

to sampling and nonsampling

error. All comparisons presented in

this report have taken sampling

error into account and are significant at the 90-percent confidence

level. This means the 90-percent

confidence interval for the difference between the estimates being

compared does not include zero.

Nonsampling errors in surveys may

be attributed to a variety of

sources, such as how the survey

was designed, how respondents

interpret questions, how able and

willing respondents are to provide

correct answers, and how accurately the answers are coded and classified. The Census Bureau employs

quality control procedures throughout the production process including the overall design of surveys,

the wording of questions, review

of the work of interviewers and

coders, and statistical review of

reports to minimize these errors.

The Survey of Income and Program

Participation weighting procedure

uses ratio estimation, whereby sample estimates are adjusted to independent estimates of the national

population by age, race, sex, and

Hispanic origin. This weighting partially corrects for bias due to undercoverage, but biases may still be

present when people who are

missed by the survey differ from

those interviewed in ways other

than the age, race, sex, and

Hispanic origin. How this weighting

procedure affects other variables in

the survey is not precisely known.

All of these considerations affect

comparisons across different surveys or data sources.

For further information on the

source of the data and accuracy of

the estimates including standard

errors and confidence intervals, go

to www.sipp.census.gov/sipp

/sourceac/s&a96_040501.pdf or

contact Dennis Sissel of the Census

Bureau Demographic Statistical

Methods Division on the Internet at

charles.d.sissel@census.gov

MORE INFORMATION

The report is available on the

Internet (www.census.gov); search

for health insurance data by clicking on the “Subjects A-Z” link and

selecting “health insurance data”

under “H.” Additional tables presenting health insurance information from the SIPP are also available on the Internet site. 

CONTACTS

Health insurance issues:

Shailesh Bhandari

Poverty and Health Statistics

Branch

Housing and Household Economic 

Statistics Division

301-763-3213

Statistical Information Staff

301-763-3242

hhes-info@census.gov

USER COMMENTS

The Census Bureau welcomes the

comments and advice of users of

its data and reports. If you have

any suggestions or comments,

please send an e-mail inquiry to:

hhes-info@census.gov 
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