ons because they couldn't afford them. This same group was also more likely to go to an emergency room or hospital for chronic conditions than those with insurance. One-third (35%) of uninsured adults with chronic conditions visited an ER, or stayed in the hospital overnight, or did both, compared to 16% of those insured all year with a chronic condition.

Americans without health insurance were also more likely to go without recommended cancer, cholesterol, and blood pressure screenings. According to the report, only 18% of adults ages 50 to 64 who were uninsured at the time of the survey had a colon cancer screening in the past five years compared to 56% of insured adults. Similarly, fewer than half (48%) of women ages 50 to 64 who were uninsured at the time of the survey had a mammogram in the past two years, compared to three-fourths of insured women. An analysis of the health care experiences of adults released today by the Robert Wood Johnson Foundation confirms similar trends in every state. Information on this new study is available at www.covertheuninsured.org.

"These findings paint a disturbing picture of the day-to-day impact of being uninsured on the physical as well as financial health of millions of Americans," said Sara Collins, Commonwealth Fund Senior Program Officer, and the study's lead author. "The uninsured are more likely to go without preventive care or screening tests that could prevent more serious and costly health problems. For an uninsured person who is unlucky enough to get sick, it is easy to see how quickly they can fall into a downward spiral of debt, forgone care, and poorer health." Researchers also found that being uninsured exacerbates existing problems with efficiency in health care. The uninsured are less likely than the insured to have a regular doctor, and are more likely to endure the effects of our fragmented health care system as they move from one place of care to another. Nearly one-quarter (23%) of a
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