This paper examines the role that population vulnerabilities play in insurance coverage for a representative sample of Latinos and Asians in the United States. Using data from the National Latino and Asian American Study (NLAAS), these analyses compare coverage differences among and within ethnic subgroups, across states and regions, among types of occupations, and among those with or without English language proficiency. Extensive differences exist in coverage between Latinos and Asians, with Latinos more likely to be uninsured. Potential explanations include the type of occupations available to Latinos and Asians, reforms in immigration laws, length of time in the United States, and regional differences in safety-net coverage. Policy implications are discussed.
References
1.
Abe-KimJ.TakeuchiD.HwangW., 2002. Predictors of Help Seeking for Emotional Distress among Chinese Americans: Family Matters. Journal of Counseling and Clinical Psychology70 (5): 1186–1190.
2.
AlegríaM.TakeuchiD.CaninoG.DuanN.ShroutP.MengX-L.VegaW.ZaneN.VilaD.WooM.VeraM.GuarnacciaP.Aguilar-GaxiolaS.SueS.EscobarJ.LinK.GongF., 2004. Considering Context, Place and Culture: The National Latino and Asian American Study. International Journal of Methods in Psychiatric Research13 (4): 208–220.
3.
AlegríaM.VilaD.WooM.CaninoG.TakeuchiD.VeraM.FeboV.GuarnacciaP.Aguilar-GaxiolaS.ShroutP., 2004. Cultural Relevance and Equivalence in the NLAAS Instrument: Integrating Etic and Emic in the Development of Cross-Cultural Measures for a Psychiatric Epidemiology and Services Study of Latinos. International Journal of Methods in Psychiatric Research13 (4): 270–288.
4.
AndersonM.FienbergS., 1999. Who Counts?: The Politics of Census-taking in Contemporary America. New York: Russell Sage Foundation.
5.
BerkM.SchurC.ChavezL.FrankelM., 2000. Health Care Use among Undocumented Latino Immigrants. Health Affairs19 (4): 51–64.
6.
BrownR.OjedaV.WynR.LevanR., 2000. Racial and Ethnic Disparities in Access to Health Insurance and Health Care. Los Angeles: UCLA Center for Health Policy Research & Henry J. Kaiser Family Foundation.
7.
CappsR.KuL.FixM., 2002. How Are Immigrants Faring after Welfare Reform? Preliminary Evidence from Los Angeles and New York City. Washington, D.C.: The Urban Institute.
8.
CappsR.PasselJ., 2004. Describing Immigrant Communities (presentation). Washington, D.C.: The Urban Institute.
9.
ClaxtonG.HolveE.FinderB.GabelJ.PickreignJ.WhitmoreH., 2003. Employer Health Benefits: 2003 Annual Survey. Menlo Park, Calif.: The Henry J. Kaiser Family Foundation and the Health Research and Educational Trust.
10.
CooperP.SchoneB., 1997. More Offers, Fewer Takers for Employment-based Health Insurance. Health Affairs16 (6): 142–149.
11.
De la TorreA.FriisR.HunterH., 1996. Health Insurance Status of U.S. Latino Women: A Profile from the 1982–1984 HHANES. American Journal of Public Health86 (4): 533–537.
12.
DeNavas-WaltC.ProctorB.LeeC., 2005. Income, Poverty, and Health Insurance Coverage in the United States: 2004. Washington, D.C.: U.S. Census Bureau and Government Printing Office.
13.
DushiI.HonigM., 2004. Offers or Take-up: Explaining Minorities' Lower Health Insurance Coverage. Economic Research Initiative on the Uninsured (ERIU) working paper. Ann Arbor, Mich.
14.
FeldP.PowerB., 2000. Immigrants' Access to Health Care after Welfare Reform: Findings from Focus Groups in Four Cities. Washington, D.C.: Kaiser Commission on Medicaid and the Uninsured.
15.
FronstinP.GoldbergL.RobinsP., 1997. Differences in Private Health Insurance Coverage for Working Male Hispanics. Inquiry34: 171–180.
16.
GinzbergE.1991. Access to Health Care for Hispanics. Journal of the American Medical Association265 (2): 238–247.
17.
GuzmanB.2001. The Hispanic Population: Census 2000 Brief. Washington, D.C.: U.S. Census Bureau.
18.
HallA.CollinsK.GliedS., 1999. Employer-sponsored Health Insurance: Implications for Minority Workers. New York: The Commonwealth Fund.
19.
HamiltonB.SuttonP.VenturaS., 2003. Revised Birth and Fertility Rates for the 1990s and New Rates for Hispanic Populations, 2000 and 2001: United States. National Vital Statistics Reports, Centers for Disease Control and Prevention51 (12).
20.
HeeringaS.WagnerJ.TorresM.DuanN.AdamsT.BerglundP., 2004. Sample Designs and Sampling Methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research13 (4): 221–240.
Institute of Medicine. 2002. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, D.C.: The National Academies Press.
23.
Kaiser Commission on Medicaid and the Uninsured. 2003. Immigrants' Health Care Coverage and Access. Washington, D.C.: The Henry J. Kaiser Family Foundation.
24.
KochharR.2005. Latino Labor Report, 2004: More Jobs for New Immigrants, but at Lower Wages. Washington, D.C.: Pew Hispanic Center.
25.
KochharR.SuroR.TafoyaS., 2005. The New Latino South: The Context and Consequences of Rapid Population Growth. Washington, D.C.: Pew Hispanic Center.
26.
KuL.MataniS., 2001. Left Out: Immigrants' Access to Health Care and Insurance. Health Affairs20 (1): 247–256.
27.
KuL.WaidmannT., 2003. How Race/Ethnicity, Immigration Status, and Language Affect Health Insurance Coverage, Access to Care and Quality of Care Among the Low-Income Population. Washington, D.C.: The Henry J. Kaiser Family Foundation.
28.
LeeS.1998. Asian Americans: Diverse and Growing. Population Bulletinvol. 53. Washington D.C.: Population Reference Bureau.
29.
MargolisM.1995. Brazilians and the 1990 United States Census: Immigrants, Ethnicity, and the Undercount. Human Organization54 (1): 52–59.
30.
MillsR.BhandariS., 2003. Health Insurance Coverage in the United States: 2002. Washington, D.C.: U.S. Census Bureau.
31.
MurphyD.2003. New Californian Identity Predicted by Researchers. New York Times Feb 17.
32.
OjedaV.BrownE., 2005. Mind the Gap: Parents' Citizenship as a Predictor of Latino Children's Health Insurance. Journal of Health Care for the Poor and Underserved16 (3): 555–575.
33.
ParkE.ParkJ., 2005. Probationary Americans: Contemporary Immigration Policies and the Shaping of Asian American Communities. New York: Routledge.
34.
PasselJ.SuroR., 2005. Rise, Peak, and Decline: Trends in U.S. Immigration 1992–2004. Washington, D.C.: Pew Hispanic Center.
35.
PennellB.BowersA.CarrD.ChardoulS.CheungG.DinkelmannK.GeblerN.HansenS.PennellS.TorresM., 2004. The Development and Implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. International Journal of Methods in Psychiatric Research13 (4): 241–269.
36.
PerkinsJ.2003. Ensuring Linguistic Access in Health Care Settings: An Overview of Current Legal Rights and Responsibilities. Washington, D.C.: The Henry J. Kaiser Family Foundation.
37.
PollackH.KronebuschK., 2004. Health Insurance and Vulnerable Populations. In Health Policy and the Uninsured, McLaughlinC., ed. Washington, D.C.: Urban Institute Press.
38.
ReevesJ.BennettC., 2004. We the People: Asians in the United States. Washington, D.C.: U.S. Census Bureau.
39.
RyuH.YoungW.KwakH., 2002. Differences in Health Insurance and Health Service Utilization Among Asian Americans: Method for Using the NHIS to Identify Unique Patterns Between Ethnic Groups. International Journal of Health Planning and Management17: 55–68.
40.
SchickF.SchickR., 1991. Statistical Handbook on U.S. Hispanics. Phoenix, Ariz.: Oryx Press.
41.
SchurC.FeldmanJ., 2001. Running in Place: How Job Characteristics, Immigrant Status, and Family Structure Keep Hispanics Uninsured. New York: The Commonwealth Fund.
42.
ShiL.2000. Vulnerable Populations and Health Insurance. Medical Care Research and Review57 (1): 110–134.
43.
Stata Statistical Software: Release 8. College Station, Texas: StataCorp.
44.
U.S. Bureau of Labor Statistics. 2004. Employed Persons by Occupation, Race, Hispanic or Latino Ethnicity, and Sex. Washington, D.C.: U.S. Bureau of Labor Statistics.
45.
U.S. Census Bureau. 2004. Educational Attainment in the United States: 2003. Washington, D.C.: U.S. Census Bureau.
46.
U.S. General Accounting Office (GAO). 1998. Decennial Census: Overview of Historical Census Issues. Washington, D.C.: U.S. GAO.
47.
VitulloM.TaylorA., 2002. Latino Adults' Health Insurance Coverage: An Examination of Mexican and Puerto Rican Subgroup Differences. Journal of Health Care for the Poor and Underserved13 (4): 504–525.
48.
WangM.HolahanJ., 2003. The Decline in Medicaid Use by Non-citizens since Welfare Reform. Washington, D.C.: The Urban Institute.
49.
ZimmermannW.TumlinK., 2003. Patchwork Policies: State Assistance for Immigrants under Welfare Reform. Washington, D.C.: The Urban Institute.
50.
ZuvekasS.TaliaferroG., 2003. Pathways to Access: Health Insurance, the Health Care Delivery System, and Racial/Ethnic Disparities, 1996–1999. Health Affairs22 (2): 139–153.
