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Debra L. Blackwell, Ph.D., NCHS/DHIS LaJeana Howie, MPH, NCHS/OAEHP

Health Insurance among Hispanics in the United States: National Health Interview Survey, 1998-2000. Debra L. Blackwell, Ph.D., NCHS/DHIS LaJeana Howie, MPH, NCHS/OAEHP. Background. Levels of non-coverage in 1997: 33% of Hispanic persons 12% of non-Hispanic white persons

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Debra L. Blackwell, Ph.D., NCHS/DHIS LaJeana Howie, MPH, NCHS/OAEHP

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  1. Health Insurance among Hispanics in the United States: National Health Interview Survey, 1998-2000 Debra L. Blackwell, Ph.D., NCHS/DHIS LaJeana Howie, MPH, NCHS/OAEHP

  2. Background Levels of non-coverage in 1997: 33% of Hispanic persons 12% of non-Hispanic white persons 19% of non-Hispanic black persons Source: 1997 NHIS Summary Statistics report on the U.S. Population

  3. Research Questions • Do all Hispanic subgroups have the same level of non-coverage? • What characteristics are associated with a lack of health insurance coverage? • Who is most likely to be uninsured?

  4. National Health Interview Survey, 1998-2000 • Three years of data Adults 18-64 years of age • Files used: Person files –> Spouse file Family files • Analyses were weighted. • Sudaan was used for variance estimation.

  5. Subgroups included in Analyses • Mexican-Americans • Puerto Ricans • Cubans • Other Latin Americans • Multiple or non-specified Hispanics • Non-Hispanic blacks • Non-Hispanic whites

  6. Health Insurance Coverage Status • Not covered • Covered • Refused, Not ascertained, Don’t know

  7. Non-insurance by subgroup type, NHIS, 1998-2000Adults 18 years of age and over, age-adjusted percents

  8. Immigrant-Citizenship status • Not US born, not US citizen (6%) • Not US born, naturalized US citizen (5%) • Unknown (1%) • US born, US citizen (88%) – baseline

  9. Employment status • Full-time/workplace insurance offered • Full-time/workplace insurance not offered • Full-time/workplace insurance unknown • Part-time/workplace insurance offered • Part-time/workplace insurance not offered • Part-time/workplace insurance unknown • Employment status unknown • Not employed – baseline

  10. Variables in adult model Subgroup type Age Sex Immigrant-citizenship status Health status Family’s health Family income Poverty status Region MSA Marital status Family size Education (own or spouse’s) Home tenure status Employment status Spouse’s workplace offers insurance coverage

  11. Results CharacteristicOdds RatioC.I. Male 1.29 (1.25, 1.33) Baseline: Females 18-30 years of age 1.83 (1.72, 1.94) 31-45 years of age 1.67 (1.59, 1.76) Baseline: Persons 46-64 years of age Divorced/Separated 1.31 (1.22, 1.39) Living with a partner 1.91 (1.77, 2.06) Baseline: Married persons

  12. CharacteristicOdds RatioC.I. Mexican-American 1.53 (1.41, 1.66) Other Latin American 1.32 (1.17, 1.49) Mult/Non-sp Hispanic 1.41 (1.24, 1.61) Non-Hispanic black 1.16 (1.09, 1.23) Baseline: Non-Hispanic white adults Language of Interview – Spanish 1.45 (1.31, 1.61) Baseline: English Not US born/not citizen 1.91 (1.77, 2.06) Baseline: US born persons

  13. CharacteristicOdds RatioC.I. Less than HS education 2.46 (2.29, 2.65) GED 2.90 (2.60, 3.25) HS Graduate 2.20 (2.05, 2.36) Some college 1.51 (1.41, 1.62) Baseline: Persons with a college degree

  14. CharacteristicOdds RatioC.I. Near poor 1.40 (1.30, 1.51) Baseline: Not poor persons Less than $20,000 2.70 (2.41, 3.03) $20,000-$34,999 2.55 (2.36, 2.76) $35,000-$54,999 1.73 (1.60, 1.87) Baseline: Persons w/ family incomes equal/above $55,000

  15. CharacteristicOdds RatioC.I. Person in fair health 0.81 (0.75, 0.88) Person in poor health 0.51 (0.45, 0.58) Baseline: Persons in excellent health 1+ family members in fair/poor health 1.23 (1.12, 1.36) Baseline: Persons in families whose members are in good/very good/excellent health

  16. CharacteristicOdds RatioC.I. Emp FT, wrkplace ins offered 0.23 (0.22, 0.25) Emp FT, wrkplace ins not offered 2.59 (2.46, 2.73) Emp PT, wrkplace ins offered 0.43 (0.39, 0.47) Emp PT, wrkplace ins not offered 1.47 (1.39, 1.56) Baseline: Non-employed persons

  17. CharacteristicOdds RatioC.I. Spouse’s wrkplace offers ins 0.34 (0.32, 0.36) Spouse’s wrkplace does not offer ins 1.50 (1.42, 1.59) Baseline: Unmarried persons South region 1.65 (1.54, 1.77) West region 1.22 (1.12, 1.32) Baseline: Persons residing in the Northeast

  18. CharacteristicOdds RatioC.I. Mexican male, emp FT, no wrkplace ins 1.86 (1.64, 2.11) Baseline: All other persons (except Otr LA males, working FT, no wrkplace ins offered) Otr LA male, emp FT, no wrkplace ins 1.65 (1.35, 2.02) Baseline: All other persons (except Mexican-American males, working FT, no wrkplace ins offered)

  19. Conclusions • Cubans and Puerto Ricans no more likely than non-Hispanic white adults to lack health insurance coverage • Mexican Americans, Other Latin Americans, and Hispanics who did not specify a particular origin or specified multiple Hispanic origins significantly more likely than non-Hispanic whites to lack coverage • Introduction of relevant controls does not “explain away” this effect.

  20. Where to get more info about the NHIS…. NHIS web-site: http://www.cdc.gov/nchs/nhis.htm To join the NHIS listserve: go to http://www.cdc.gov/subscribe.html and follow instructions.

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