By Jonathan Miller, Project Associate.
The recent ruling from the Supreme Court upholding the individual
mandate to purchase health care insurance is a defining moment for the
future of care in America. As Stephanie Allen wrote earlier this week (Economic Development Rx)
regarding the effect of the ruling on economic development, “Whatever
else the health care bill is or may do, its aim is to make the people in
communities across America healthier. And, a healthier community is a
more vibrant and more productive one.” So, the question becomes, where
are the communities that stand to gain the most from the individual
The following is a ranked list of the top 20 American cities that have
the highest concentrations of uninsured people (the U.S. average is set
to 1.0, so a value of 2.35 indicates that there are 2.35 times more
uninsured people in the metro than in the U.S. as a whole). The table
also contains the percent of uninsured and the percent of uninsured
children (under the age of 18).
American Cities with Highest Concentrations of Uninsured Persons, 2010
Source: U.S. Census Bureau, American Community Survey
The list of cities is dominated by those in Sunbelt states, reaching
from South Carolina all the way to New Mexico. Yakima, Washington is
outside of the Sunbelt geography, but is in the part of Washington that
is actually sundrenched (I should know, I grew up in Seattle).
The presence of 12 Texas cities on the list is intriguing as the
productivity gains that could accrue in these cities - think healthy
workers are less likely to use sick days and be stuck with crushing
medical debt - have not been the rhetorical focus of Texas lawmakers
(Gov. Rick Perry called the law a “stomach punch to the American
Whether you are for or against the health care reform and the individual
mandate, there should be consensus that many cities and regions have
much to gain, regardless of political ideology.