Heterogeneity in Health Insurance Coverage Among US Latino Adults
Heterogeneity in Health Insurance Coverage Among US Latino Adults
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DOI：
10.1007/s11606-009-1069-7
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发表时间：
2009-11-01
影响因子：
5.7
通讯作者：
Ortega, Alexander N.
中科院分区：
文献类型：
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作者：
Bustamante, Arturo Vargas;Fang, Hai;Ortega, Alexander N.
我们试图确定影响美国拉丁裔成年人和墨西哥血统的美国拉丁裔成年人之间健康保险覆盖率的观察和未观察因素的差异。我们的假设是，墨西哥血统的拉美裔人的健康保险覆盖范围比非墨西哥拉美裔人要差。1999 年至 2007 年的国家健康访谈调查 (NHIS) 数据库包含 33,847 名拉美裔人。我们在健康保险覆盖范围的初步描述性分析中将墨西哥血统的拉丁裔与非墨西哥裔拉丁裔进行了比较。随后在多变量逻辑回归框架中分析了拉丁裔类别之间健康保险覆盖范围的差异，该框架针对混杂变量进行了调整。应用布林德-瓦哈卡技术将健康保险覆盖范围的差异解析为观察到的和未观察到的部分。墨西哥血统的美国拉美裔人的健康保险覆盖率始终低于美国非墨西哥拉美裔人。这些差异中大约 65% 可归因于美国墨西哥裔人口特征的差异（例如年龄、性别、收入、就业状况、教育、公民身份、语言和健康状况）。其余的差异可能归因于未观察到的异质性，其中可能包括未观察到的就业相关信息（例如，就业类型和公司规模）以及行为和特质因素（例如，风险厌恶和文化差异）。这项研究证实，墨西哥血统的拉丁裔美国人比非墨西哥裔拉丁裔美国人拥有健康保险的可能性较小。此外，虽然观察到的社会经济和人口因素的差异造成了这些差异的大部分，但未观察到的异质性所占的比例却占了这些差异的 35%。
We sought to determine the differences in observed and unobserved factors affecting rates of health insurance coverage between US Latino adults and US Latino adults of Mexican ancestry. Our hypothesis was that Latinos of Mexican ancestry have worse health insurance coverage than their non-Mexican Latino counterparts.The National Health Interview Survey (NHIS) database from 1999-2007 consists of 33,847 Latinos. We compared Latinos of Mexican ancestry to non-Mexican Latinos in the initial descriptive analysis of health insurance coverage. Disparities in health insurance coverage across Latino categories were later analyzed in a multivariable logistic regression framework, which adjusts for confounding variables. The Blinder-Oaxaca technique was applied to parse out differences in health insurance coverage into observed and unobserved components.US Latinos of Mexican ancestry consistently had lower rates of health insurance coverage than did US non-Mexican Latinos. Approximately 65% of these disparities can be attributed to differences in observed characteristics of the Mexican ancestry population in the US (e.g., age, sex, income, employment status, education, citizenship, language and health condition). The remaining disparities may be attributed to unobserved heterogeneity that may include unobserved employment-related information (e.g., type of employment and firm size) and behavioral and idiosyncratic factors (e.g., risk aversion and cultural differences).This study confirmed that Latinos of Mexican ancestry were less likely to have health insurance than were non-Mexican Latinos. Moreover, while differences in observed socioeconomic and demographic factors accounted for most of these disparities, the share of unobserved heterogeneity accounted for 35% of these differences.