Young Adults Seeking Medical Care: Do Race and Ethnicity Matter?
Barbara Bloom, M.P.A. and Robin A. Cohen, Ph.D.
Key findings
Data from the National Health Interview Survey: 2008–2009
• More than one-half of Hispanic young adults aged 20–29 years were uninsured in 2008–2009 compared with one-third of non-Hispanic black young adults and almost one-quarter of non-Hispanic white young adults.
• Among young adults aged 20–29 years, non-Hispanic white (66%) young adults were twice as likely as Hispanic (33%) young adults to have private health insurance coverage.
• Approximately equal percentages of Hispanic, non-Hispanic white, and non-Hispanic black young adults with private health insurance or Medicaid had a usual source of medical care.
• Uninsured non-Hispanic white (37%) and non-Hispanic black (33%) young adults were more likely to have unmet medical need than uninsured Hispanic (21%) young adults.
Health care disparities among different racial and ethnic subgroups in the United States are of national concern. Health insurance is a key factor in the access to medical care services, and young adults in the United States aged 20–29 years are more likely than adults aged 30 years and over to lack health insurance coverage (1–4). A previous report has examined the differences in health insurance and access to health care by gender among young adults aged 20–29 years (5). This report focuses on the differences in health insurance and access to health care among Hispanic, non-Hispanic white, and non-Hispanic black young adults aged 20–29 years.
Does health insurance coverage differ by race and ethnicity
for young adults?
• More than one-half of Hispanic young adults aged 20–29 years were uninsured in 2008–2009 compared with one-third of non-Hispanic black young adults and almost one-quarter of non-Hispanic white young adults.
• Non-Hispanic white (66%) young adults were twice as likely as Hispanic (33%) young adults and one and one-half times as likely as non-Hispanic black (43%) young adults to have private health insurance coverage.
• Non-Hispanic black (20%) young adults were more likely to have Medicaid coverage than Hispanic (12%) young adults or non-Hispanic white (8%) young adults.
Does access to medical care differ by race and ethnicity for young adults?
• Hispanic (55%) young adults aged 20–29 years were less likely to have had a usual source of medical care than non-Hispanic black (68%) or non-Hispanic white (72%) young adults.
• Approximately equal percentages of Hispanic, non-Hispanic white, and non-Hispanic black young adults had a usual source of medical care, for those with private health insurance (79%–81%) or Medicaid (82%–85%).
• Among uninsured young adults, non-Hispanic white (47%) and non-Hispanic black (40%) young adults were more likely to have had a usual source of medical care than Hispanic (33%) young adults.
Does having a doctor visit in the past year differ by race and ethnicity for
young adults?
• Overall, non-Hispanic white (76%) and non-Hispanic black (76%) young adults aged 20–29 years were more likely to have had a doctor visit in the past year than Hispanic (61%) young adults.
• Non-Hispanic white (80%) and non-Hispanic black (81%) young adults with private insurance were more likely to have had a doctor visit in the past year than Hispanic (74%) young adults with the same coverage.
• Non-Hispanic white young adults with Medicaid (88%) were more likely to have had a doctor visit in the past year than Hispanic young adults with the same coverage (80%).
• Uninsured non-Hispanic white (60%) and non-Hispanic black (60%) young adults were more likely to have had a doctor visit in the past year than uninsured Hispanic (47%) young adults.
Does emergency room use differ by race and ethnicity for young adults?
• Overall, non-Hispanic black (14%) young adults aged 20–29 years were more likely than non-Hispanic white (9%) or Hispanic (8%) young adults to have had two or more emergency room visits in the past year.
• Among young adults with private health insurance, approximately equal percentages of Hispanic (6%), non-Hispanic white (7%), and non-Hispanic black (8%) young adults had two or more emergency room visits in the past year.
• Non-Hispanic black young adults with Medicaid (27%) were more likely to have had two or more emergency room visits in the past year than Hispanic young adults with the same coverage (18%).
• Uninsured non-Hispanic white (11%) and non-Hispanic black (12%) young adults were about twice as likely to have had two or more emergency room visits in the past year as uninsured Hispanic (6%) young adults.
Does unmet medical need differ by race and ethnicity for young adults?
• Overall, non-Hispanic white (17%) or non-Hispanic black (18%) young adults aged 20–29 years were more likely to have had unmet medical need due to cost in the past year than Hispanic (15%) young adults.
• Among young adults with private insurance, non-Hispanic white (10%) young adults were more likely than Hispanic (8%) young adults to have had unmet medical need due to cost.
• Non-Hispanic white young adults with Medicaid (14%) were more likely to have had unmet medical need due to cost than Hispanic young adults with Medicaid (8%).
• Uninsured non-Hispanic white (37%) and non-Hispanic black (33%) young adults were more likely to have had unmet medical need than uninsured Hispanic (21%) young adults.
Summary
Hispanic young adults were less likely than black or white young adults to have health insurance coverage. Since coverage affords access to the health care system, it is not surprising that Hispanic young adults were less likely than non-Hispanic white or black young adults to have had a usual source of medical care or to have had a doctor visit in the past year. Insured young adults were more likely than uninsured young adults to have access to the medical system and to use medical services. Among insured young adults, approximately equal percentages of those within each racial and ethnic group had a usual source of medical care. However, among those with private insurance, Hispanic young adults were less likely than non-Hispanic white and black young adults to have had a doctor visit in the past year. Within each racial and ethnic group, uninsured young adults were about three times as likely as those with private insurance to have had unmet medical need. However, the level of unmet need varied; uninsured non-Hispanic white (37%) and non-Hispanic black (33%) young adults were more likely to have had unmet medical need than uninsured Hispanic (21%) young adults. This report shows that among young adults aged 20–29 years, there are racial and ethnic
disparities in health insurance coverage, in the receipt of health care services, and in the level of unmet need. The disparities in the receipt of health care services were mitigated to some extent by having health insurance coverage.
About the Authors
Barbara Bloom and Robin A. Cohen are with the Centers for Disease Control and Prevention’s National Center for Health Statistics, Division of Health Interview Statistics.
References
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