MINORITY HEALTH: Access, Affordability Contribute to High Uninsurance Rate
While California's robust economy has boosted the employment rate among minorities, it has not helped them increase their access to affordable health insurance, according to three reports from the UCLA Center for Health Policy Research. In fact, the number of nonelderly minorities who are uninsured has remained steady, or in some cases increased, despite overall higher employment levels. "More people are working, but they are not getting health insurance as a part of their reward. When it comes to health insurance, many minority workers are, in effect, penalized because they don't receive all the benefits of working," said Rebecka Levan, lead author of one study (UCLA release, 4/26). Levan and colleagues found that Latinos are more than twice as likely than whites to go without health coverage -- 36% compared with 15% -- due mainly to a lack of job-based coverage. But affordability, poverty, lack of education, low-skill occupations and lack of citizenship are other factors contributing to the disparity (Levan et al., "Disparity in Job- Based Health Coverage," 4/99). A lack of job-based coverage is also one of the main reasons 21% of African Americans are uninsured, but Medi-Cal cutbacks are also responsible, according to another study. But the disparity remains even when workplace differences between whites and blacks are adjusted. For example, blacks who work at large companies -- which are the most likely to provide coverage -- have health insurance less often than their white peers who work in the same environment (Cunningham et al., "African Americans Remain Uninsured," 4/99). Medi-Cal cuts also contributed to high uninsurance rates among Asian Americans and Pacific Islanders -- 24% in 1997, up from 21% in 1995. However, job-based insurance, privately purchased insurance and other public insurance remain fairly stable among this demographic (Levan et al., "Declining Medi-Cal Coverage," 4/99). "Our findings are an indictment of the system as inequitable," said E. Richard Brown, study co-author and director of the UCLA center. "Affordability remains the fundamental problem all these people face. Given their incomes, they are not likely to be able to addresses these problems on their own," he said. Brown and colleagues recommend that the state expand government-sponsored health programs for the poor, noting that the state is leaving untouched $1.5 billion in federal funds that it could use for health insurance programs. The reports, which can be read in PDF format at www.healthpolicy.ucla.edu , were funded by the Kaiser Family Foundation and are based on analysis of the National Health Interview Survey from 1993 and 1994 and the Current Population Survey from 1997 and 1998 (release, 4/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.