Claudia L. Schur and Jacob Feldman, Project HOPE Center for Health Affairs.
The alarmingly low rates of health care coverage within the nation's Hispanic population have been well documented. While much of the problem can be attributed to a lack of access to employer-based health insurance, this new Commonwealth Fund report reveals that immigrant status and family structure appear to play a role as well.
According to Running In Place: How Job Characteristics, Immigrant Status, and Family Structure Keep Hispanics Uninsured, Hispanics under age 65 are more than twice as likely as non-Hispanic whites to be uninsured and only 60 percent as likely to have coverage through an employer, based on 1997 data. For their analysis, authors Claudia L. Schur, Ph.D., and Jacob Feldman, Ph.D., of the Project HOPE Center for Health Affairs examined data from the National Health Interview Survey, the Survey of Income and Program Participation, and the Current Population Survey.
Schur and Feldman discovered that while more than one-third (35%) of all Hispanics lacked insurance in 1997, the highest uninsured rates within the Hispanic population were among people of Mexican origin (38%) and immigrants from Central and South America (39%). Uninsured rates among Cubans (22%) and Puerto Ricans (19%) were lowest. Half of Hispanics born outside the United States were uninsured in 1997, compared with one-quarter of U.S.-born Hispanics.
The study also finds that nearly three-quarters of Hispanics who have lived in the United States less than five years are uninsured. Even after 15 years in the United States, one-third of foreign-born Hispanics remain uninsured, compared with only 14 percent of foreign-born non-Hispanics. In the job market, Hispanics are at a double disadvantage. First, they are more likely than non-Hispanics to be employed in industries and occupations that do not offer health benefits. Second, within these industries, they are less likely than non-Hispanics to be offered coverage by their firm. Within the construction industry, for example, 64 percent of non-Hispanic whites are offered and eligible for coverage, compared with 46 percent of Hispanics. Yet when they are offered a health plan, Hispanics are just as likely to enroll. Fewer than 70 percent of full-time Hispanic workers were offered health insurance in 1999, versus nearly 90 percent of non-Hispanic whites.
Family characteristics may also contribute to Hispanics' high uninsured rates. According to the study, married Hispanics are younger than married whites, more likely to have young children at home, and more likely to be part of a family with only one worker-factors that limit the avenues through which they can obtain health coverage.
Facts and Figures