Hispanics and health insurance coverage: the rising disparity.
BACKGROUND
Many reports have focused attention on the rising percentage of adults in the United States without health insurance. This hides the fact that the uninsured rate for non-Hispanic nonelderly adults has held fairly steady since 1983, while the rate for Hispanics has increased.


OBJECTIVE
To document the trends in the coverage rate by source of coverage for different population groups between 1983 and 2003 and suggest how changes in the composition of these groups have contributed to these trends.


METHODS
We stack panels of the Survey of Income and Program Participation to create a nationally representative 20-year pooled cross-section of nonelderly adults. We calculate actual trends in insurance coverage as well as 2 hypothetical time series that disentangle the effect of the decreasing coverage rate for Hispanics from the growth of the Hispanic adult population.


RESULTS
Although the increase in uninsured rate is largest for Hispanic noncitizens, US-born Hispanics also have a significant upward trend, primarily driven by a decrease in private coverage, with little change in public coverage. Although the increase in the Hispanic population contributed to the increase in the number of uninsured adults, the widening coverage disparity was more important.


CONCLUSIONS
Hispanic nonelderly adults, both US-born and immigrants, have fallen behind non-Hispanic nonelderly adults in insurance coverage. Although combinations of economic growth and private and public insurance policy changes have maintained, and in some cases improved, overall coverage rates for non-Hispanics, these changes have not helped Hispanic adults, leading to increased disparities in coverage.
Rutledge
Matthew S
MS
Department of Economics, University of Michigan, Ann Arbor, Michigan 48109-1220, USA. rutledma@umich.edu
McLaughlin
Catherine G
CG
D000293:Adolescent; D000328:Adult; D019352:Censuses; D003430:Cross-Sectional Studies; D003710:Demography; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000639:trends*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000639:trends; D007348:Insurance, Health / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000208:ethnology*; D008875:Middle Aged; D011158:Population Growth; D011632:Public Assistance / Q000331:legislation & jurisprudence / Q000639:trends*; D012946:Social Welfare / Q000208:ethnology* / Q000331:legislation & jurisprudence / Q000639:trends; D012959:Socioeconomic Factors; D014481:United States