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NIOSH Releases: Health Insurance Coverage Among Working Adults

June 1, 2018
NIOSH Update:
Press Contact: Nura Sadeghpour (202) 245-0673

Study estimates percentages of workers who have no health insurance by their occupation

business man pointing to a blue hexagon titled insurance

Researchers from the National Institute for Occupational Safety and Health (NIOSH) recently found that the estimated percentage of workers aged 18‒64 years who had health insurance increased by approximately 3.3 percentage points (or 21%) from 2013 to 2014. However, the percentage of workers who had no health insurance varied significantly depending on their occupation.

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. In January 2014, during this study period, the federal requirement to obtain qualifying health insurance began. In order to observe differences in health insurance coverage by occupation, researchers grouped workers into 22 broad occupational categories and looked at survey responses from 17 states. (Findings from 17 states may not necessarily be nationally representative.)

“Identifying factors affecting differences in coverage by occupation might help to address health disparities among occupational groups,” said Winifred L. Boal, MPH, research epidemiologist and lead author of the study.

The study delineates lowest and highest percentages of being uninsured in 2014 by workers’ occupations:

  • On the low end, 2.7% of workers in community and social services occupations and education, training and library occupations were uninsured in 2014.
  • On the high end, 37.0% of workers in building and grounds cleaning and maintenance occupations were uninsured in 2014.
  • More than 25% of workers in four occupational groups were uninsured in 2014: construction and extraction; farming, fishing, and forestry; food preparation and serving related; and the highest, building and grounds cleaning and maintenance.
  • Among the occupations with the highest percentages of uninsured workers, farming, fishing, and forestry and construction and extraction, are also among the most hazardous.

There can be several reasons why workers in specific occupations remain uninsured, including not being able to qualify for Medicaid and/or living in a state that did not expand Medicaid eligibility, not being able to afford coverage, and not having employers who provide health insurance.

Please access the study Health Insurance Coverage by Occupation Among Adults Aged 18–64 Years — 17 States, 2013–2014 here.

NIOSH is the federal institute that conducts research and makes recommendations for preventing work-related injuries, illnesses, and deaths. For more information about NIOSH visit