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Workplace factors, length of U.S. residency, and language barriers contribute to lack of insurance among Hispanics

Hispanics are more likely to have no health insurance than non-Hispanic whites and blacks. Workplace factors, time lived in the United States, and language barriers all play different roles in the lack of insurance among various Hispanic groups, according to a study by Margaret Weigers Vitullo, Ph.D., of Gallaudet University, and Amy K. Taylor, Ph.D., of the Agency for Healthcare Research and Quality. They used data from the 1996 Household Component of AHRQ's Medical Expenditure Panel Survey (MEPS), which included 5,000 Hispanics, to examine factors linked to lack of health insurance among nonelderly Mexican American and Puerto Rican adults living in the United States.

Workplace characteristics were a major factor influencing Hispanic insurance coverage. Hispanics were more frequently employed in low-wage jobs than blacks and non-Hispanic whites (24 vs. 15 and 9 percent, respectively) and small firms (44 vs. 34 and 41 percent, respectively), which are less likely to offer health insurance. They also were more likely to be employed in industries that do not typically offer health insurance, such as agriculture and construction. Thus, despite similar rates of full-time employment among these three groups, Hispanic adults were less likely to have private insurance (49 percent) than blacks (56 percent) and whites (78 percent) and more likely to have no health insurance at all (40 vs. 29 and 16 percent, respectively).

Time lived in the United States was a major factor associated with being uninsured for Mexican Americans, particularly those who had lived in the United States less than 10 years. Undocumented immigrants, individuals without green cards, and in some cases anyone who was not a U.S. citizen may not have been eligible for public health insurance. However, since Puerto Rico is a U.S. territory, Puerto Ricans are American citizens at birth, and residency was not a barrier to obtaining Medicaid insurance. This helps explain why 27 percent of Puerto Ricans had public insurance versus only 11 percent of Mexican Americans. For Puerto Ricans, language was a major factor limiting access to private health insurance.

More details are in "Latino adults' health insurance coverage: An examination of Mexican and Puerto Rican subgroup differences," by Drs. Vitullo and Taylor, in the Journal of Health Care for the Poor and Underserved 13(4), pp. 504-525, 2002.

Reprints (AHRQ Publication No. 03-R007) are available from the AHRQ Publications Clearinghouse.

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