Contrary to popular belief, communities with high levels of uninsured or immigrant residents generally have lower rates of hospital emergency department use than other communities, according to a new study by the Center for Studying Health System Change. Published online by Health Affairs, the study concludes that much of the considerable variation in ED use across communities is not explained by differences in population, and that continued increases in ED use nationally are more likely to be driven by increased demand for health care in general. “Although rising uninsurance rates might not raise ED visit rates among the population, higher levels of uncompensated ED visits in many hospitals are likely to result, especially in public hospitals and other safety-net hospitals that tend to serve a high proportion of uninsured people,” the authors add. Caroline Steinberg, AHA vice president for trends analysis, said the findings are not surprising. “The sad fact is that people without health insurance seek less care, but when they do they are more likely to be sicker, because they put off care,” she said.