title: Health insurance coverage among diabetic adults from three major ethnic groups in the United States.
abstract: OBJECTIVE
  The lack of adequate health insurance may result in a downward spiral of the diabetic condition, imposing an increased financial strain on family and the society as a whole. The objective of our study was to assess the insurance type and coverage among diabetic adults from three major ethnic groups.
  
  
  METHODS
  We used data of two cross-sectional national surveys to estimate insurance coverage among diabetic adults aged 20-64 years, 1988-1994 and 2003-2008.
  
  
  RESULTS
  The prevalence of doctor-diagnosed diabetes has increased by 120%, 178% and 135% respectively among non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexicans & other Hispanics (M&OHs) from 1988-94 to 2003-08. However, during the same period, the percentages of diabetic adults covered by health insurance declined for all three groups. In the 2003-08 period, 15%, 19% and 40% of NHWs, NHBs and M&OHs, respectively, had no insurance. Diabetic NHBs and NHWs had an equal likelihood to be covered by government-sponsored programs. However, 70% of NHWs, in contrast to 37% of NHBs, were covered by private programs exclusively. Diabetic M&OHs remained at the lowest likelihood to be covered by government-sponsored programs. The diabetic citizen's probability of being insured was more than tripled compared with the non-citizens (OR=3.40, 95%=1.42-8.14).
  
  
  CONCLUSIONS
  Increasing percentages of diabetics had no insurance. Diabetic Whites were more likely to be covered by private programs than diabetic Blacks. Hispanics were the group falling through the cracks between private programs due to low income and government programs because of immigration status.
authors.affiliation: Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA.
authors.forename: Linda I
authors.initials: LI
authors.lastname: Ekperi
authors.forename: Shamola
authors.initials: S
authors.lastname: Greene
authors.forename: Ahmed
authors.initials: A
authors.lastname: Dehal
authors.forename: Ana
authors.initials: A
authors.lastname: Lòpez-De Fede
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000191:economics* / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult