Marked ethnic, nativity, and socioeconomic disparities in disability and health insurance among US children and adults: the 2008-2010 American community survey.
We used the 2008-2010 American Community Survey Micro-data Sample (N = 9,093,077) to estimate disability and health insurance rates for children and adults in detailed racial/ethnic, immigrant, and socioeconomic groups in the USA. Prevalence and adjusted odds derived from logistic regression were used to examine social inequalities. Disability rates varied from 1.4% for Japanese children to 6.8% for Puerto Rican children. Prevalence of disability in adults ranged from 5.6% for Asian Indians to 22.0% among American Indians/Alaska Natives. More than 17% of Korean, Mexican, and American Indian children lacked health insurance, compared with 4.1% of Japanese and 5.9% of white children. Among adults, Mexicans (43.6%), Central/South Americans (41.4%), American Indians/Alaska Natives (32.7%), and Pakistanis (29.3%) had the highest health-uninsurance rates. Ethnic nativity disparities were considerable, with 58.3% of all Mexican immigrants and 34.0% of Mexican immigrants with disabilities being uninsured. Socioeconomic gradients were marked, with poor children and adults having 3-6 times higher odds of disability and uninsurance than their affluent counterparts. Socioeconomic differences accounted for 24.4% and 60.2% of racial/ethnic variations in child health insurance and disability and 75.1% and 89.7% of ethnic inequality in adult health insurance and disability, respectively. Health policy programs urgently need to tackle these profound social disparities in disability and healthcare access.
US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA.
Gopal K
GK
Singh
Sue C
SC
Lin
D000293:Adolescent; D000328:Adult; D001213:Asian; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007348:Insurance, Health; D008297:Male; D017058:Mexican Americans; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States / Q000208:ethnology