National surveys have shown that increasingly many Americans believe that uninsured people get the health care they need. The figure recently jumped to 57 percent in 1999--up from 43 percent in 1993. But a new study from scientists at Harvard Medical School shows that this popular view just isn't correct. "Many uninsured adults are going without proper medical attention," says lead author John Ayanian. "Thirty-two percent of women without health insurance for over a year report not getting a mammogram in the past two years. Twenty-six percent of the long-term uninsured with hypertension or diabetes say they haven't had a check-up with a doctor in two years. From a public health perspective, these numbers are very concerning." The study--which analyzed survey data collected from more than 220,000 adults in 1997 and 1998--appears in this week's issue of the Journal of the American Medical Association.

Among the findings are the following facts: Some 14 percent of those polled lacked health insurance; nearly 10 percent had gone without health insurance for at least a year; and two thirds of the nation's uninsured adults have not had insurance for more than a year. Approximately two fifths of those without insurance for more than a year and a third of the short-term uninsured people surveyed reported that cost prevented them from seeing a physician when needed during the previous year. Nearly 70 percent of long-term uninsured people who were also in poor health were unable to see a doctor as required. And cost presented the greatest barrier for women, blacks, the unemployed and low-income earners. "Long-term uninsured adults, particularly those in poor health or with chronic medical conditions, are a high-risk group for complications and early death," Ayanian notes, "and many of these adults are not receiving the medical care they need."