Journal of Adolescent Health
Volume 39, Issue 5 , Pages 627-633, November 2006

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.

  • S. Todd Callahan, M.D., M.P.H.

      Affiliations

    • Child and Adolescent Health Research Unit, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
    • Corresponding Author InformationAddress correspondence to: Dr. S. Todd Callahan, Division of Adolescent Medicine, Vanderbilt Children’s Hospital, 436 Medical Center South, Nashville, TN 37212-3100.
  • ,
  • Gerald B. Hickson, M.D.

      Affiliations

    • Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee
  • ,
  • William O. Cooper, M.D., M.P.H.

      Affiliations

    • Child and Adolescent Health Research Unit, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee

Received 4 January 2006; accepted 20 April 2006. published online 28 June 2006.

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.

Keywords: Access to care, Young adults, Hispanic Americans, Uninsurance

 

PII: S1054-139X(06)00145-5

doi:10.1016/j.jadohealth.2006.04.012

Journal of Adolescent Health
Volume 39, Issue 5 , Pages 627-633, November 2006