Abstract
In the United States, having health insurance is an important determinant of health care access and individual health outcomes. Nationwide, a significant proportion of the population does not have health insurance. Hispanics, in particular, are less likely than non-Hispanics to have insurance. A framework was established to examine the relationships between the determinants of insurance coverage and health care affordability in El Paso County, Texas. Data from the 2005 Behavioral Risk Factor Surveillance System were used to examine the relationships described by this framework. The sample included 653 adults, of those 477 self-identified as Hispanic or Latino. In El Paso County, almost half of adult Hispanics lack any type of health insurance coverage, three times the rate of non-Hispanics. Among Hispanics, the lack of health insurance was strongly associated with reduced affordability of health care. Employment status, income, and age were found to have significant associations with insurance coverage and health care affordability. Sex and education level were relevant, yet distal determinants of these outcomes. Ongoing conversations about health care reform should take into account the patterns of coverage within the Hispanic population. Knowing how economic and social factors affect coverage is necessary to inform policy that can effectively alleviate disparities experienced by Hispanics.
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Hadley J. Sicker and poorer–the consequences of being uninsured: a review of the research on the relationship between health insurance, medical care use, work, and income. Med Care Res Rev. 2003;60(Suppl 2): 3S–75S (discussion 76S–112S).
Schoen C, DesRoches C. Uninsured unstably insured: the importance of continuous insurance coverage. Health Serv Res. 2000;35(1 Pt 2):187–206.
DeNavas-Walt C, Proctor B, Smith J. Income, poverty, and health insurance coverage in the United States: 2006. Washington, DC: US Government Printing Office; 2007. p. 60–233.
Department of Health and Human Services. Overview of the uninsured in the United States: an analysis of the 2005 current population survey. ASPE office of health policy. Office of the Assistant Secretary for Planning and Evaluation: Washington, DC; 2005.
Fronstin P. Sources of health insurance and characteristics of the uninsured: analysis of the March 2006 current population survey. EBRI Issue Brief. 2006;1(298):4–30.
Adams P, Barnes P. Summary of health statistics for the US population: National Health Interviews Survey, 2004. Hyattsville, MD: National Center for Health Statistics; 2006 (DHHS Pub. No. [PHS] 2006–1557).
Graves J, Long S. Why do people lack health insurance? Urban Institute. (2006). Available at http://www.urban.org/url.cfm?ID=411317.
Doty M, Holmgren A. Health care disconnect: gaps in coverage and care for minority adults: findings from the Commonwealth Fund biennial health insurance survey (2005). The Commonwealth Fund. (2006). Available at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=386220.
Schur C, Feldman J. Running in place: how job characteristics, immigrant status, and family structure keep Hispanics uninsured. Project Hope Center for Health Affairs, The Commonwealth Fund. (2001). Available at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=221348.
US Census Bureau. American Fact Finder. Suitland, Maryland. (2008). Available at http://factfinder.census.gov/home.
Brown E, Wyn R, Teleki S. Disparities in health insurance and access to care for residents across US cities. The Commonwealth Fund and UCLA Center for Health Policy Research. (2000). Available at http://www.healthpolicy.ucla.edu/pubs/files/DisparitiesInHealthInsuranceReport(MSA).pdf.
Texas Department of State Health Services. Primary Care HPSA Designations. Austin, TX. (2009). Available at http://www.dshs.state.tx.us/CHS/HPRC/PChpsaPT.shtm.
Byrd T, Law J. Cross-border utilization of health care services by United States residents living near the Mexican border. Rev Panam Salud Publica. 2009;26(2):95–100.
Nelson D, Holtzman D, Bolen J, Stanwyck C, Mack K. Reliability and validity of measures from the behavioral risk factor surveillance system (BRFSS). Soz Praventivmed. 2001;46(Suppl 1):S3–42.
Carrasquillo O, Carrasquillo A, Shea S. Health insurance coverage of immigrants living in the United States: differences by citizenship status, country of origin. Am J Public Health. 2000;90(6):917–23.
Heyman JM, Núñez GG, Talavera V. Health care access and barriers for unauthorized immigrants in El Paso County, Texas. Family & community health. 2009;32(1):4–21.
Escobedo L, Cardenas V. Utilization purchase of medical care services in Mexico by residents in the United States of America, 1989–1999. Rev Panam Salud Publica. 2006;19(5):300–5.
Landeck M, Garza C. Utilization of physician health care services in Mexico by US Hispanic border residents. Health Mark Q. 2002;20(1):3–16.
Macias E, Morales L. Crossing the border for health care. J Health Care Poor Underserved. 2001;12(1):77–87.
Pylpa J. Self-medication practices in two California Mexican communities. J Immigr Health. 2001;3(2):59–75.
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Law, J., VanDerslice, J. Proximal and Distal Determinants of Access to Health Care among Hispanics in El Paso County, Texas. J Immigrant Minority Health 13, 379–384 (2011). https://doi.org/10.1007/s10903-010-9327-7
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DOI: https://doi.org/10.1007/s10903-010-9327-7