MINORITY HEALTH: Racial Groups Have Reduced Access Care
Ethnic and racial groups continue to "bear a disproportionate burden of mortality and morbidity across a wide range of health conditions," a situation which is "compounded by reduced access to health care services," according to a new report from the Kaiser Family Foundation and the UCLA Center for Health Policy Research. The report, "Racial and Ethnic Disparities in Access to Health Insurance and Health Care," used data from the Current Population Survey and the National Health Interview Survey to compare insurance coverage and access to care among Latinos, African Americans, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives. For some ethnic and racial groups, health disparities "begin early in life and are sustained throughout the lifecourse," but the report notes that "good access to appropriate health services could reduce many of these disparities." The report found the following:
- Latinos: Of the ethnic groups surveyed, Latinos are the most likely to be uninsured, with 37% of nonelderly Latinos lacking health insurance. Fifty-eight percent of Latino noncitizens are uninsured, while 27% of Latinos who are U.S. citizens are uninsured. Part of the problem, the report notes, is that only 43% of Latinos have employer-based insurance, compared to 73% of whites. At the same time, the percentage of Latinos who had Medicaid coverage dropped from 20% in 1994 to 16% in 1997. Possibly because of their lack of insurance, Latinos also are the most likely of all ethnic groups to lack a usual source of care. Twelve percent of Latino children and 26% of Latino adults lack a usual source of care.
- African Americans: Twenty-three percent of African Americans are uninsured -- one-and-a-half times the uninsured rate for whites. African Americans' Medicaid coverage dropped 5% between 1994 and 1997, from 24% to 19%. At the same time, 53% of African Americans have employer-based insurance, compared to 73% of whites. While African Americans are just as likely as whites to have a usual source of care, "large proportions" of uninsured children and adults lack an "ongoing connection to the health care system." Of uninsured African-American children ages 0-5, 10% have not visited a physician during a 12-month period, while 20% of uninsured children ages 6-17 have not visited a physician in the last two years.
- Asian Americans and Pacific Islanders: Twenty-one percent of Asian Americans and Pacific Islanders are uninsured, compared to 14% of whites. Among AAPIs, Medicaid coverage is low, with 1%-2% of Chinese, Japanese, Filipinos and Koreans and 20% of Southeast Asians having Medicaid coverage. Eight percent of insured children ages 0-5 have not seen a doctor in the last year, while 12% of children ages 6-17 have not had a physician visit in the last two years. Nineteen percent of uninsured children ages 6-17 have not seen a physician in the last two years.
- American Indians and Alaskan Natives: While the Indian Health Service under HHS is required to provide and administer health services for much of the AI/AN population, only 20% of AI/ANs report having IHS coverage. For those reporting IHS coverage, 34% also have job-based or private coverage and 20% also have Medicaid coverage. Thirty-five percent of uninsured AI/ANs lack a usual source of care, a figure which is three times higher than for AI/ANs who have insurance (Brown et al., report, 8/1). A full copy of the report is available at http://www.kff.org/content/2000/1525/UCLAReport.pdf