One in 5 North Carolinians lacks health insurance

April 27, 2012
One in five people in North Carolina under age 65 lacked health insurance in 2010 — an increase from previous estimates completed five years earlier — according to a new study from the North Carolina Institute of Medicine (NCIOM).

The analysis, which compared 2004-2005 data with 2009-2010 data, showed that 291,000 non-elderly North Carolina residents were added to the ranks of the uninsured, an increase of 2.4 percent of the population. Overall, the state had 1.6 million uninsured residents.

Dr. Pam Silberman

Dr. Pam Silberman

“These new data will provide valuable insights as we strive to improve the health of North Carolinians,” said Pam Silberman, NCIOM president and clinical professor of health policy and management at UNC’s Gillings School of Global Public Health.

“Policymakers, health-care professionals, insurers and community groups can use this information to better address the needs of the uninsured and the factors contributing to North Carolinians living without health insurance,” Silberman added.

While the majority of the uninsured live in families with at least one full-time worker, the study found a notable increase in the number who lived in families with no workers, part-time workers or only one full-time worker.

Dr. Mark Holmes

Dr. Mark Holmes

Mark Holmes, PhD, assistant professor of health policy and management at the public health school, said this may be a reflection of tough economic times.

“The recession has led to an increased proportion of adults being unemployed and losing their employer-based coverage,” said Holmes, who led the study. “This ‘recently uninsured’ population might benefit from strategies quite different from the long-term uninsured.”

Holmes also is director of the N.C. Rural Health Research and Policy Analysis Center at UNC’s Cecil G. Sheps Center for Health Services Research and former vice president of NCIOM.

In addition to the statewide analysis, NCIOM released county-level data, including rankings, for North Carolina’s 100 counties. Greene County had the highest percentage of uninsured residents, at 25 percent, while Catawba County had the lowest, at 16.5 percent.

“The county-level data can be especially useful to community collaborations of safety net providers designed to meet the health care needs of local uninsured populations,” Holmes said. “By better understanding the population in their community, they can more efficiently design their services and capacity. Furthermore, these data can be very helpful in demonstrating need to public and private funders assisting with the cost of services for the uninsured.”

The Patient Protection and Affordable Care Act could extend coverage to many of the uninsured. If upheld by the courts, uninsured North Carolinians with incomes below 138 percent of the federal poverty level may be eligible for Medicaid coverage. In addition, many uninsured North Carolinians with incomes below 400 percent of the federal poverty level will be eligible for subsidies to purchase health insurance coverage through a newly created Health Benefits Exchange.

County-level estimates were developed using data from the U.S. Census Bureau and the North Carolina Employment Security Commission.

NCIOM is an independent agency, chartered by the North Carolina General Assembly to provide balanced, nonpartisan information on issues of relevance to the health of North Carolina’s population.

Visit for more information about the study.



UNC Gillings School of Global Public Health contact: Linda Kastleman, communications editor, (919) 966-8317 or