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Health Insurance Enrollment Declining in Industries with Large Minority Workforces

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Press Release Date: April 17, 2001

Industries with large minority work forces are trailing those dominated by white employees in the percentage of workers enrolling in employer-paid health insurance and the gap is widening, according to a new study supported by the U.S. Agency for Healthcare Research and Quality (AHRQ). The study, which was based on Census Bureau data on 197 industries between 1988 and 1997, compared health insurance enrollment across industries and over time.

AHRQ Director John M. Eisenberg, M.D., said, "Studies such as this are critical to informing policymakers and employers of where and to what extent health coverage gaps exist between population groups." Dr. Eisenberg added that AHRQ recently launched a $45 million research program aimed at reducing racial and ethnic disparities in health care.

"This study opens a window on how a changing American labor force has affected the distribution of health insurance," said principal investigator, Lisa A. Cubbins, Ph.D., of Seattle's Battelle Memorial Research Institute.

The study also showed that since 1988:

  • Workers are less likely to receive health benefits in industries with higher proportions of small firms, a trend that grew during the decade. In the opinion of the researchers, rising health care costs were a contributing factor.
  • Higher levels of full-time employees (35 hours or more a week) in an industry increased the likelihood of health benefits, although the magnitude of this effect declined during the decade.
  • Lower unemployment rates and increased demand for labor during the past decade seem to have contributed to an increase in the percent of workers receiving health benefits in industries with proportionately more part-time labor. According to the researchers, this may be because the high demand for labor in the mid-1990s led employers to use different incentives, such as health benefits, to attract part-time workers.
  • The gap in health benefit levels between retail trade and nonprofessional service industries versus other types of industries widened, contributing toward the long-term decline in employer-based health insurance.
  • There was no change in the impact of union activity on the level of health benefits, but the researchers hypothesize that as the labor movement extends its membership to include groups of workers who lack health benefits, the effect of unions on health benefits may become stronger.

Simulations conducted by the researchers suggest that the decline in employer health benefits may be less dramatic over the next few years, compared with that of the last two decades. They project that the average proportion of workers provided health benefits across industries by 2007 will be 47.8 percent compared to 50.3 percent in 1997.

Details are in "Economic Change and Health benefits: Structural Trends in Employer-based Health Insurance," in the just-published March 2001 issue of Journal of Health and Social Behavior.

Note to Editors: For interviews of Dr. Cubbins, please contact Battelle's media relations manager, Katy Delaney, at (614) 424-5544.

For more information, please contact Robert Isquith, (301) 427-1539 or


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