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Health Insurance Gap Persists Among Latino, Black and White Americans
Drop in Employer Health Coverage for Latinos Suggests Economic Downturn Took Greater Toll; Wide Gaps in Access to Care Between Minorities and Whites Remain
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ASHINGTON, D.C.The health insurance gap among Latino, black and white Americans persisted in 2003, with one in three Latinos, one in five blacks and one in 10 whites under age 65 lacking health insurance, according to a national study released today by the Center for Studying Health System Change (HSC).
Overall health insurance rates changed little between 2001 and 2003 among nonelderly blacks, whites and Latinos, but sources of coverage shiftedespecially for Latinosfrom job-based to public coverage, suggesting the economic downturn took a greater toll on Latinos, according to findings from HSCs 2003 Community Tracking Study Household Survey, a nationally representative survey involving information on about 47,000 people. Increases in public coverageprimarily Medicaid and the State Childrens Health Insurance Program-among all three ethnic and racial groups helped offset declines in employer health coverage.
The proportion of nonelderly Latinos with employer health coverage declined more than 7 percentage points between 2001 and 2003, from 47.8 percent to 40.4 percent. In comparison, 53.9 percent of nonelderly blacks and 73.5 percent of whites had employer health coverage in 2003, according to the study. The drop in employer coverage was especially striking among Latino children, with employer coverage declining from 43.3 percent of Latino children in 2001 to 34.5 percent in 2003.
"Increased reliance on public coverage can be viewed either as an encouraging developmenta result of expanded eligibility and outreachor a worrisome oneminorities disproportionately losing job-based coverage," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.
Shifting sources of health coverage had little effect on access to medical care between 2001 and 2003. With the sole exception of decreased access to specialists among blacksthe percentage of blacks whose last doctor visit was to a specialist declined from 24.4 percent in 2001 to 19.8 percent in 2003access to care measures did not change significantly.
However, significant gaps in access to care persisted among racial and ethnic groups, with Latinos and blacks consistently reporting lower levels of access than whites. For example, Latinos and blacks are less likely than whites to have a regular caregiver, less likely to see a physician and more likely to see physicians in emergency rooms. When they do see physicians, blacks and Latinos are less likely than whites to see a specialist.
"As long as blacks and Latinos have greater problems getting medical care, its unlikely that health disparities will diminish significantly," said J. Lee Hargraves, Ph.D., author of the study and an HSC consulting researcher and associate professor at the University of Massachusetts Medical School.
The study is detailed in a new HSC Tracking ReportTrends in Health Insurance Coverage and Access Among Black, Latino and White Americans, 2001-2003. Other key findings include:
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.