6. Access to health insurance comes primarily through the workplace and has important health consequences.

Work is the portal for a number of health-related benefits and programs, the most important of which is health insurance. The percentage of Californians receiving health insurance through employment trails the nation by 11 percentage points, yet remains the vehicle through which most Californians (58 percent) are insured.³⁰ Access to health insurance has important implications for health behaviors and, ultimately, health outcomes. Nearly one-third of uninsured, nonelderly adults in California report that in 1999 they did not seek medical care when they needed it. Uninsured adults are also less likely to have access to preventive care than those with health insurance coverage, resulting in lower rates of receiving blood pressure checks, routine checkups, Pap smears, dentist visits, teeth cleanings and preventive counseling. Lack of preventive care is particularly significant for the uninsured because they report higher rates of unhealthy behaviors than the insured, including smoking and being overweight, which place them at significantly higher risk for future disease and premature death. Finally, uninsured adults in California are more than twice as likely as the insured to report their health as fair or poor and less likely to report their health as excellent or good than are insured Californians.