Abstract
OBJECTIVES: This study examined health insurance coverage among immigrants who are not US citizens and among individuals from the 16 countries with the largest number of immigrants living in the United States. METHODS: We analyzed data from the 1998 Current Population Survey, using logistic regression to standardize rates of employer-sponsored coverage by country of origin. RESULTS: In 1997, 16.7 million immigrants were not US citizens. Among non-citizens, 43% of children and 12% of elders lacked health insurance, compared with 14% of non-immigrant children and 1% of non-immigrant elders. Approximately 50% of non-citizen full-time workers had employer-sponsored coverage, compared with 81% of non-immigrant full-time workers. Immigrants from Guatemala, Mexico, El Salvador, Haiti, Korea, and Vietnam were the most likely to be uninsured. Among immigrants who worked full-time, sociodemographic and employment characteristics accounted for most of the variation in employer health insurance. For Central American immigrants, legal status may play a role in high un-insurance rates. CONCLUSIONS: Immigrants who are not US citizens are much less likely to receive employer-sponsored health insurance or government coverage; 44% are uninsured. Ongoing debates on health insurance reform and efforts to improve coverage will need to focus attention on this group.
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- Akin B. V., Rucker L., Hubbell F. A., Cygan R. W., Waitzkin H. Access to medical care in a medically indigent population. J Gen Intern Med. 1989 May-Jun;4(3):216–220. doi: 10.1007/BF02599526. [DOI] [PubMed] [Google Scholar]
- Halfon N., Wood D. L., Valdez R. B., Pereyra M., Duan N. Medicaid enrollment and health services access by Latino children in inner-city Los Angeles. JAMA. 1997 Feb 26;277(8):636–641. [PubMed] [Google Scholar]
- Himmelstein D. U., Woolhandler S., Wolfe S. M. The vanishing health care safety net: new data on uninsured Americans. Int J Health Serv. 1992;22(3):381–396. doi: 10.2190/5FBA-VEKK-K2DK-JF8V. [DOI] [PubMed] [Google Scholar]
- Hubbell F. A., Waitzkin H., Mishra S. I., Dombrink J., Chavez L. R. Access to medical care for documented and undocumented Latinos in a southern California county. West J Med. 1991 Apr;154(4):414–417. [PMC free article] [PubMed] [Google Scholar]
- Kraut A. M. Healers and strangers. Immigrant attitudes toward the physician in America--a relationship in historical perspective. JAMA. 1990 Apr 4;263(13):1807–1811. doi: 10.1001/jama.263.13.1807. [DOI] [PubMed] [Google Scholar]
- Lewin-Epstein N. Determinants of regular source of health care in black, Mexican, Puerto Rican, and non-Hispanic white populations. Med Care. 1991 Jun;29(6):543–557. doi: 10.1097/00005650-199106000-00013. [DOI] [PubMed] [Google Scholar]
- Siddharthan K. Health insurance coverage of the immigrant elderly. Inquiry. 1991 Winter;28(4):403–412. [PubMed] [Google Scholar]
- Solis J. M., Marks G., Garcia M., Shelton D. Acculturation, access to care, and use of preventive services by Hispanics: findings from HHANES 1982-84. Am J Public Health. 1990 Dec;80 (Suppl):11–19. doi: 10.2105/ajph.80.suppl.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Swartz K. Interpreting the estimates from four national surveys of the number of people without health insurance. J Econ Soc Meas. 1986 Oct;14(3):233–242. [PubMed] [Google Scholar]
- Takeuchi D. T., Chung R. C., Shen H. Health insurance coverage among Chinese Americans in Los Angeles County. Am J Public Health. 1998 Mar;88(3):451–453. doi: 10.2105/ajph.88.3.451. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thamer M., Richard C., Casebeer A. W., Ray N. F. Health insurance coverage among foreign-born US residents: the impact of race, ethnicity, and length of residence. Am J Public Health. 1997 Jan;87(1):96–102. doi: 10.2105/ajph.87.1.96. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Treviño F. M., Moyer M. E., Valdez R. B., Stroup-Benham C. A. Health insurance coverage and utilization of health services by Mexican Americans, mainland Puerto Ricans, and Cuban Americans. JAMA. 1991 Jan 9;265(2):233–237. doi: 10.1001/jama.1991.03460020087034. [DOI] [PubMed] [Google Scholar]
- Treviño R. P., Treviño F. M., Medina R., Ramirez G., Ramirez R. R. Health care access among Mexican Americans with different health insurance coverage. J Health Care Poor Underserved. 1996 May;7(2):112–121. doi: 10.1353/hpu.2010.0022. [DOI] [PubMed] [Google Scholar]