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Knowledge of Health Insurance Terms and the Affordable Care Act in Racially and Ethnically Diverse Urban Communities

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Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Confusion around health insurance reforms persist. The purpose of this study was to assess demographic differences in Affordable Care Act (ACA) and health insurance knowledge in a multi-ethnic urban sample. Data came from 243 adults from racial/ethnic communities. Participants were asked about elements of health insurance and the ACA. Generalized linear and logistic regression models were used to examine relationships between demographic predictors and knowledge domains. Female gender (p < 0.05) and Latino/Hispanic race/ethnicity (p < 0.001) were most predictive of lower eligibility knowledge, while non-citizen with residency status (p < 0.001) and other/not declared residency status (p < 0.001) were most predictive of lower insurance coverage knowledge. No demographic factors predicted enrollment knowledge. Latino/Hispanic race/ethnicity (p < 0.01) was most predictive of not knowing that more people can get insurance because of the ACA. In conclusion, there is variation in health insurance and ACA-related knowledge in multi-ethnic populations. More compatible health communication interventions are needed to support outreach to key demographic groups.

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Acknowledgements

This study was funded through the National Institute for Health Care Reform (Grant No. UM#N019071). We would like to acknowledge the contributions of all the individuals at our partner sites who have contributed to this study: Latino Family Services, Community Health and Social Services (CHASS) Center, Arab Community Center for Economic and Social Services (ACCESS), Covenant Community Care, Mercy Primary Care Center, Enroll America, the Michigan Primary Care Association and the Health Disparities Reduction and Minority Health Section of the Michigan Department of Community Health. We appreciate the support provided by the Detroit Community-Academic Urban Research Center. We thank Honey Locust Health, study staff and participants.

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Authors and Affiliations

  1. Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Minal R. Patel, Lindsay TerHaar, Alyssa Smith & Katherine Worthington

  2. Arab Community Center for Economic and Social Services, Dearborn, MI, USA

    Madiha Tariq

  3. Health Disparities Reduction/Minority Health Section, Michigan Department of Health and Human Services, Lansing, MI, USA

    Jacquetta Hinton

  4. Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA

    Richard Lichtenstein

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  1. Minal R. Patel
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  2. Lindsay TerHaar
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Correspondence to Minal R. Patel.

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Patel, M.R., TerHaar, L., Smith, A. et al. Knowledge of Health Insurance Terms and the Affordable Care Act in Racially and Ethnically Diverse Urban Communities. J Immigrant Minority Health 22, 456–466 (2020). https://doi.org/10.1007/s10903-019-00924-3

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