Original article
Health Care Access of Hispanic Young Adults in the United States

This work was presented in part at the annual meeting of the Pediatric Academic Societies, San Francisco, California, May 4, 2004.
https://doi.org/10.1016/j.jadohealth.2006.04.012Get rights and content

Abstract

Purpose

Hispanic persons in the United States experience higher rates of many chronic conditions than non-Hispanic whites. Access to care, especially during young adulthood, may afford opportunities for prevention or early management of these conditions. Given the heterogeneity of the Hispanic population, the specific aims of this study were to assess health insurance coverage and health care access and utilization for different Hispanic subgroups young adults in the U.S.

Methods

We analyzed data from 5189 Hispanic and 13,214 white young adults (19–29 years old) completing the National Health Interview Survey (NHIS) from 1999–2002. Health care access/utilization measures included reports of 1) uninsurance, 2) lacking a usual source of care, 3) no health professional contact, and 4) delaying needed care because of cost. Multivariate analyses were used to estimate the risk of access barriers after adjusting for sociodemographic variables and citizenship.

Results

Young adults of Central/South American, Mexican, or Puerto Rican origins were more likely than whites to be uninsured (28%–64% vs. 22%; p < .01) and this was especially true for noncitizens. Central/South American and Mexican young adults without U.S. citizenship were most likely to be uninsured (63% and 73%, respectively). The majority of noncitizens also lacked a usual source of care and had no health professional contact in the prior year. After adjustment, the risk of uninsurance was 60% higher for Mexican and Central/South American young adults relative to white peers. Mexican young adults also had higher risk of lacking a usual source of care and having no health professional contact.

Conclusions

Substantial variability in rates of uninsurance and health care access/utilization measures exist among subgroups of Hispanic young adults participating in the NHIS. U.S. citizenship and sociodemographic factors explain much, but not all of the differences.

Section snippets

Methods

We analyzed data from the National Health Interview Survey (NHIS) for the years 1999–2002. Conducted by the National Center for Health Statistics (NCHS) of the Centers for Disease Control, the NHIS uses a nationally representative sampling strategy to provide ongoing, cross-sectional data about the health and health care of the civilian noninstitutionalized U.S. population [27]. The NHIS oversamples the Hispanic U.S. population to improve the precision of health estimates and conducts surveys

Statistical Analyses

Population estimates and bivariate distributions of sociodemographic characteristics, health insurance status, and health care access and utilization measures are presented using weighted data from 5189 Hispanic young adults (stratified by national origin subgroup and U.S. citizenship) and 13,214 white non-Hispanic young adults. Four multiple logistic regression models were created to estimate the adjusted odds of reporting (1) no health insurance, (2) no usual source of care, (3) delayed or

Sociodemographic Characteristics

The Central/South American, Mexican (including Mexican American) and Puerto Rican respondents participating in the NHIS represent an estimated 5.7 million young adults and 14% of all 19–29-year-olds in the U.S. (Table 1). Hispanic young adults were less likely than non-Hispanic white peers to have attended college, more likely to be working at a job that did not offer health insurance, and more likely to live in a household with an income of less than $20,000. These findings were particularly

Discussion

A large body of literature details poor health care access among Hispanics in the United States, and an increasing number of studies demonstrates the poor health care access of young adults. This study examines the common ground of these two populations—Hispanic young adults in the U.S. As hypothesized, this study finds that Hispanic young adults in general have higher uninsurance rates and are more likely to lack a usual source of health care and report having no contact with a health

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