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• Currently, the United States has the greatest inequality among rich countries—and the worst health inequities. Between 1980 and 2000, the average life expectancy for the economically fortunate in America has increased 3.4 years, from 75.8 to 79.2 years. During that same period, the life expectancy for the least fortunate increased only 1.7 years, from 73.0 to 74.7. Thus, on average, wealthy Americans can expect to live 4.5 years longer than poor Americans (Economic Policy Institute, Growing Disparities in Life Expectancy, 7/16/2008).
  
  
• Lower socioeconomic status in childhood has been linked repeatedly with lower educational and income levels in adulthood, which in turn predict health status. Thus, poor Americans are not only more likely to die before wealthy Americans, but they are also more likely to suffer from illnesses throughout their lives.
  
  
  • Children in poor families are about seven times as likely to be in poor or fair health as children in the highest-income families.
    
    
  • Poor adults are three times as likely to have a chronic disease that limits their activity, twice as likely to have diabetes, and are nearly 50% more likely to die of heart disease.
    
    
  • Eleven percent of adults living below the poverty line had asthma compared to 6% of those with a family income of 200% or more above the poverty level.
    
    
• The United States spends more money on health per capita than any other country, and U.S. health spending continues to increase. In 2006, national health care expenditures in the United States totaled $2.1 trillion. The average per capita expenditure on health in the United States was $7,026 in 2006.
  
  
• The current economic recession has resulted in mass employee layoffs across the United States. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) grants workers who leave their jobs the option to retain their employer-sponsored health care for 18 months (29 months for the disabled)—at their own expense—after their employment ends (Kaiser Family Foundation, Health Coverage During Unemployment, 12/2008 and Economic Policy Institute, Costly Cobra).
  
  
  • In theory, COBRA coverage is supposed to provide continuity to those between jobs—a small comfort when one is abruptly laid-off and searching for another means of support.
    
    
  • In practice, COBRA coverage has not helped soothe many minds, as out-of-work Americans find their COBRA premiums impossible to afford. The average monthly health care premium for a family is $1,057; and the average monthly unemployment benefits a person receives is $1,437. An unemployed head of household would have to pay roughly 74% of his/her income to retain his/her health insurance.

• 17.2% of North Carolinians (1,547,212 residents) lacked health insurance in 2007.
• 25.9% of North Carolinians were covered by either Medicaid or Medicare.
• 50.3% of North Carolinians participated in an employer-sponsored health care plan.
• Only 4.9% of North Carolina residents purchased individual health care plans.
  Kaiser Family Foundation, State Health Facts
  
  
• Since 2007—the onslaught of the current recession—the rate of North Carolina’s uninsured population has increased faster than that of any other state in the country. Families USA, a national nonprofit organization that advocates for high-quality, affordable health care for all Americans, reports that (Charlotte Business Journal, 7/16/2009):
  
  
  • 322,000 North Carolinians have already lost their health coverage, bringing the total of the State’s uninsured to 1.8 million.
    
    
  • Another estimated 230,000 North Carolinians are expected to lose their health care coverage by December 2010.
    
    
  • The total of number of North Carolinians who have lost or will lose their health care during this crisis is equal to 1,480 people per week.
    
    
• From 2000-2007, employer-based family health insurance premiums in North Carolina increased 5.3 times faster than median family incomes. During that period, “health care premiums for families rose 74.4 percent, while median earnings rose by only 14.0 percent” (Premiums vs. Paychecks).
  
  
  • The pain of high insurance premiums does not belong solely to working families, though. In the last eight years, NC employers’ shares of annual health insurance premiums have risen by $3,707 on average. Workers’ portion increased by $1,262 during that same period (Premiums vs. Paychecks).
    
    
• North Carolina’s children are not faring the current recession any better than their parents. 13.1% of North Carolina’s children were uninsured in 2007 (Annie E. Casey Foundation Kids Count Report).
  
  
  • 31.4% of North Carolina’s children were enrolled in Medicaid in 2004 (latest year of data for the indicator).
    
    
  • In North Carolina, children under age six are eligible for Medicaid if their families earn 200% of the federal poverty level or less (FPL).
    
    
  • Children ages six to 18 are eligible for Medicaid if their families earn up to 100% or less of the FPL (NC Department of Health and Human Services).
    
    
  • 5.4% of children were enrolled in NC Health Choice, North Carolina’s version of the federally-mandated State Children’s Health Insurance Plan (SCHIP).
    
    
  • NC Health Choice allows families with incomes up to 200% of the federal poverty level (FPL) enroll their children in this public program, though families with incomes from 150-200% of the FPL are required to make small copayments when their children seek treatment.
    
    
  • Assuming the figures for NC children enrolled in Medicaid remained steady from 2004-2007, almost 40% of North Carolina’s children were publicly insured from 2004-2007.
    
    
  • Even more children could have been insured by the State, though. The North Carolina Institute of Medicine (NCIOM) reports that three of five currently uninsured children are eligible for Medicaid or NC Health Choice

• On the whole, Forsyth County residents were faring slightly worse than those in similar North Carolina counties before the current recession. 16.5% of all Forsyth County residents were uninsured in 2005 compared to an average of 15% in similar areas.
  
  
  • NC-Catch (Comprehensive Assessment for Tracking Community Health), developed by faculty at UNC-Charlotte collects county-level data on the health and welfare of North Carolinians. NC-Catch further breaks down Forsyth County health data to uncover that in 2005:
    
    
    • 11.8% of Forsyth County children (ages 0-17) were uninsured, compared to the peer counties’ average of 9.9%.
      
      
    • 18.3% of adults between the ages of 18 and 64 were uninsured compared to 17% in similar counties.
      
      
  • By 2007, NC-Catch data presents an even more sobering picture of residents’ ability to purchase health care:
    
    
    • 17.9% of the total population of Forsyth County was eligible for Medicaid (in NC Medicaid eligibility limits are set at 100% of FPL), whereas 14.4% of residents in similar counties were eligible for public insurance.
      
      
• The Annie E. Casey Foundation’s Kids Count data on Forsyth County children reports that 14.5% of Forsyth County children were uninsured in 2007.
  
  
• According to NC-Catch another 40.8% of children (infants to 20 years old) were eligible for Medicaid in 2007.

• Healthcare Facts: National, North Carolina, and Forsyth County
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