Access to health care and health care utilization among Hispanic/Latino women in the United States, 2000-2002

1
Access to health care and health care utilization
among Hispanic/Latino women in the United States,
2000-2002

• Gulnur Scott, M.P.A.
• Margaret Lethbridge-Çejku, PhD
• Division of Health Interview Statistics

2
Background

• Access to health care is an important determinant
  of the quality of health care, the quality and
  years of healthy life and the presence or absence
  of health disparities
• Race/ethnicity is one of the key factors that
  contributes to disparities in health and health
  care utilization
• Hispanic/Latinos are more likely to lack access
  to health care than persons of other racial and
  ethnic groups
• The Hispanic/Latino population in the US is very
  diverse
• Understanding differences among Hispanic/Latino
  subpopulations will help inform health policies
  and programs

3
Objectives

• To assess subgroup differences in access to care
  and health care utilization among Hispanic/Latino
  women by examining
• Health insurance coverage
• Having a usual place of health care
• Experiencing unmet medical need due to cost

4
Access to health care

• Health Insurance
• Insured Covered by private or public (Medicaid,
  Medicare, or other public) health insurance
• Uninsured Not covered by any kind of
  comprehensive health insurance or health care
  plan includes women with only IHS
• Usual source of care
• One or more places to go, other than hospital
  emergency room, when sick or in need of health
  advice
• Unmet medical needs
• Could not afford medical care, prescription
  medication, eye glasses, dental care, mental
  health care or counseling
• Delayed care because of cost

5
Hispanic/Latino women in the National Health
Interview Survey

• Black and Hispanic/Latino populations
  over-sampled
• Three data years combined to provide estimates
  for Hispanic/Latino subpopulations
• Hispanic/Latino women in the US, ages 18
• Hispanic/Latino subpopulations
• Mexican or Mexican-American
• Puerto Rican
• Cuban or Cuban American
• Central or South American
• Other Hispanic (Dominican Republic, Other Latin
  American, Other Hispanic/Latino)

6
Data analysis

• SUDAAN software
• Estimates weighted to reflect national estimates
• Annualized sample size3027 Hispanic/Latino women
  per year
• Annualized weighted estimate 11,159,088 (11 of
  women in US population)
• Non-Hispanic black women and non-Hispanic white
  women used as reference populations
• Three risk factors for lack of access to care
  investigated poverty (as defined by US Census),
  lack of high school education, and family size of
  6 or more members

7
Hispanic/Latino women in the U.S.
Puerto Rican
Mexican
Cuban
Central or South American
Other Hispanic
Data Source National Health Interview Survey
2000-2002
Preliminary Data
8
ACCESS TO CARE AMONG US HISPANIC/LATINO WOMEN No
health insurance coverage


Data Source National Health Interview Survey
2000-2002
Preliminary Data
9
ACCESS TO CARE AMONG US HISPANIC/LATINO WOMEN No
usual place of care


Data Source National Health Interview Survey
2000-2002
Preliminary Data
10
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Unmet medical needs


Data Source National Health Interview Survey
2000-2002
Preliminary Data
11
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Poor women without health insurance


Data Source National Health Interview Survey
2000-2002
Preliminary Data
12
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Poor women with no usual place of care


Preliminary Data
Data Source National Health Interview Survey
2000-2002
13
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Poor women with unmet medical needs


Data Source National Health Interview Survey
2000-2002
Preliminary Data
14
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Less than HS education without health
insurance


Preliminary Data
Data Source National Health Interview Survey
2000-2002
15
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Less than HS education with no usual place
of care


Data Source National Health Interview Survey
2000-2002
Preliminary Data
16
ACCESS TO CARE AMONG US HISPANIC/LATINO
WOMEN Less than HS education with unmet medical
needs


Preliminary Data
Data Source National Health Interview Survey
2000-2002
17
ACCESS TO CARE AMONG US HISPANIC/LATINO WOMEN 6
family members without health insurance


Data Source National Health Interview Survey
2000-2002
Preliminary Data
18
ACCESS TO CARE AMONG US HISPANIC/LATINO WOMEN 6
family members with no usual place of care


Preliminary Data
Data Source National Health Interview Survey
2000-2002
19
ACCESS TO CARE AMONG US HISPANIC/LATINO WOMEN 6
family members with unmet medical needs


Data Source National Health Interview Survey
2000-2002
Preliminary Data
20
Summary

• 34 of Hispanic/Latino women were uninsured, 22
  had no usual place of care, and 22 had unmet
  medical needs
• Poverty, having less than a HS education, and
  large family size were associated with lack of
  health insurance and lacking a usual place of
  care in all women, but appear to have a greater
  impact on Hispanic/Latino women
• Mexican and Central / South American women were
  disproportionately represented among
  Hispanic/Latino women who lacked insurance, a
  usual place of care, and who had unmet medical
  needs
• 75 of Hispanic/Latino women in the US are
  Mexican or Central/South American 58 are
  Mexican
• 41 of Mexican women were poor, 50 had less than
  a HS education, and 19 had large families of 6
  or more

21
Conclusions

• Disparities in access to care and health care
  utilization were found among subgroups of
  Hispanic/Latino women in the US
• Much of the disparity in access to care between
  Hispanic women and non-Hispanic white and black
  women is driven by lack of access to care among
  Mexican and Central and South American women in
  the US
• Even among women who shared characteristics shown
  to be associated with a lack of health care
  access - poverty, lack of education, and large
  family size a greater proportion of Mexican and
  Central/South American women were adversely
  impacted compared with other Hispanic/Latino
  women, and compared with non-Hispanic black and
  white women

22
Percentage of Hispanic/Latino and non-Hispanic
women in the U.S.
2000 2001 2002
Hispanic/Latino 10.7 11.0 11.3 Non-Hispanic
white 76.9 76.5 76.2 Non-Hispanic black
12.4 12.5 12.5
Data Source National Health Interview Survey
2000-2002
Preliminary Data