Journal of Immigrant and Minority Health

, Volume 14, Issue 4, pp 706–714

Where Would You Rather Live If You Were Insured? Assessing Community Uninsurance Spillover Effects on the Insured

  • Rachel R. Hardeman
  • Carolyn García
  • José A. Pagán
Original Paper

DOI: 10.1007/s10903-011-9531-0

Cite this article as:
Hardeman, R.R., García, C. & Pagán, J.A. J Immigrant Minority Health (2012) 14: 706. doi:10.1007/s10903-011-9531-0


This study sought to understand the cost, quality of, and access to health care for the insured population in the context of spillover effects resulting from community-level uninsurance. We examined the health care access, quality, and cost experienced by insured Latina mothers in two communities, Minneapolis, Minnesota and McAllen, Texas. These communities differ substantially by the size of the local population without health insurance coverage. Four focus groups were conducted with insured Latina mothers who were caring for at least one child in their household. Eleven and thirteen mothers participated in each community, respectively. The experiences of the insured population in McAllen were substantially different from the experiences of the insured population in Minneapolis. The perceptions of health care quality and access by insured Latina mothers were substantially lower in McAllen while out-of-pocket costs were perceived to be higher in Minneapolis. Our study provides key insights about the US health care system and the role that the relative size of the local uninsured population may have in impacting the health care experiences of the insured. Health insurance coverage rates are expected to increase substantially across US communities within the next few years but local health care system challenges related to cost, quality, and access will remain for both the insured and the uninsured.


Community Access Cost Quality Latinos Uninsured Insured 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Rachel R. Hardeman
    • 1
  • Carolyn García
    • 2
  • José A. Pagán
    • 3
    • 4
  1. 1.School of Public HealthUniversity of MinnesotaMinneapolisUSA
  2. 2.School of Public Health and School of NursingUniversity of MinnesotaMinneapolisUSA
  3. 3.Department of Health Management and Policy, School of Public HealthUniversity of North Texas Health Science CenterFort WorthUSA
  4. 4.Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaUSA

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