Between 1987 and 1996, the large gap in health insurance coverage experienced by most minority groups compared with white Americans remained constant and widened for Hispanic men, according to a new study by Alan C. Monheit, Ph.D., and Jessica Primoff Vistnes, Ph.D., of the Agency for Healthcare Research and Quality. Among non-elderly American workers, employment-related insurance coverage among Hispanic men declined 13 percentage points between 1987 and 1996; the decline among Hispanic and black women was 7 percentage points, while the decline was less than 3 percentage points for white men.
Declining union membership and a decline in the likelihood of being married reduced potential sources of coverage and helped to explain the drop in coverage for Hispanic men. Declines in family income also contributed to falling coverage rates for Hispanic male workers. Hispanic male workers were also unique in that, unlike other racial/ethnic groups that were either more likely to obtain offers of employment-related health insurance over the study period or had stable offer rates, Hispanic males had a decline in offer rates.
Drs. Monheit and Vistnes also found that in 1996, Hispanic males had the largest gap of all minority groups in employment-based coverage relative to white males. They attribute part of this gap to the lower education attainment, lower wages, and lower family incomes of Hispanic male workers compared with white male workers. For example, 38 percent of Hispanic men had not completed high school compared with only 10 percent of white men. In addition, nearly half of Hispanic men who were working earned less than $10 per hour compared with one-fifth of white men.
Insurance affordability and access to coverage were also a problem for other minority groups compared with white men, and this will probably continue, according to the authors. For example, fewer Hispanic and black women worked full-time (73 and 81 percent, respectively) compared with white men (91 percent), which limited their eligibility for coverage.
To narrow the gap in coverage for minorities, the authors cite the need to control health insurance costs, provide affordable insurance products, and improve minority worker skills, earnings potential, and access to jobs that provide health insurance. Their findings are based on analysis of data from two nationally representative household surveys of health care access, use, and expenditures sponsored by AHRQ: the 1987 National Medical Expenditure Survey and the 1996 Medical Expenditure Panel Survey.
See "Race/ethnicity and health insurance status: 1987 and 1996," by Drs. Monheit and Vistnes, in the November 2000 Medical Care Research and Review 57 (Suppl.1), pp. 11-35.
Reprints (AHRQ Publication No. 01-R009) are available from the AHRQ Publications Clearinghouse.