Health insurance status, lifestyle choices and the presence of non-communicable diseases: a systematic review

Abstract Background Although health insurance (HI) has effectively mitigated healthcare financial burdens, its contribution to healthy lifestyle choices and the presence of non-communicable diseases (NCDs) is not well established. We aimed to systematically review the existing evidence on the effect...

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Published in:Journal of public health (Oxford, England) England), 2024-02, Vol.46 (1), p.e91-e105
Main Authors: Folayan, Adeola, Cheong, Mark Wing Loong, Fatt, Quek Kia, Su, Tin Tin
Format: Article
Language:English
Subjects:
Choice Behavior
Exercise
Healthy Lifestyle
Humans
Insurance Coverage - statistics & numerical data
Insurance, Health
Life Style
Noncommunicable Diseases - epidemiology
Noncommunicable Diseases - prevention & control
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Summary:Abstract Background Although health insurance (HI) has effectively mitigated healthcare financial burdens, its contribution to healthy lifestyle choices and the presence of non-communicable diseases (NCDs) is not well established. We aimed to systematically review the existing evidence on the effect of HI on healthy lifestyle choices and NCDs. Methods A systematic review was conducted across PubMed, Medline, Embase, Cochrane Library and CINAHLComplet@EBSCOhost from inception until 30 September 2022, capturing studies that reported the effect of HI on healthy lifestyle and NCDs. A narrative synthesis of the studies was done. The review concluded both longitudinal and cross-sectional studies. A critical appraisal checklist for survey-based studies and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies were used for the quality assessment. Result Twenty-four studies met the inclusion criteria. HI was associated with the propensity to engage in physical activities (6/11 studies), consume healthy diets (4/7 studies), not to smoke (5/11 studies) or take alcohol (5/10 studies). Six (of nine) studies showed that HI coverage was associated with a lowered prevalence of NCDs. Conclusion This evidence suggests that HI is beneficial. More reports showed that it propitiated a healthy lifestyle and was associated with a reduced prevalence of NCDs.
ISSN:1741-3842
1741-3850
1741-3850
DOI:10.1093/pubmed/fdad247