Despite the strength of the US economy, the number of Americans without health insurance in 2004 climbed for the fourth consecutive year to a record high of 45.8m and the poverty rate also increased, according to official figures yesterday.

The data from the Census Bureau the US government statistical agency identified an 800,000 increase in uninsured Americans, who make up 15.7 per cent of the population. Although the number of Americans without healthcare was at its highest levels since records began in the mid-1980s, as a share of the population it was still down from a peak of 16.3 per cent in 1998.