TABLE 10-1 Health Insurance Coverage for U.S. Adults Aged 18-64, 2001

 

Percent Uninsured

Population

Currently

In Past Year

Total United States

16

24

White

12

20

Black

22

30

Hispanic

35

46

Mexican

39

49

Central American

47

55

Puerto Rican

16

35

Asian

14

21

Chinese

12

16

Korean

52

55

Vietnamese

32

37

Filipino

6

15

Indian

13

18

Japanese

1

4

 

SOURCES: Collins et al. (2002); Doty and Ives (2002); Hughes (2002). Data are from the Commonwealth Fund 2001 Health Care Quality Survey.

panics are also more likely than whites to receive care in nonoptimal organizational settings (such as emergency rooms) and to lack continuity in health care. Analyses of racial and ethnic differences in access to and the use of health services between 1977 and 1996 show that the black-white gap has not narrowed over time, and the gap between Hispanics and whites has widened (Weinick et al., 2000). Moreover, this study found that, even if income and health insurance coverage were equal, racial and ethnic differences in having a usual source of care and in receiving ambulatory care in the previous year would not have been eliminated, because one-half to three-quarters of the differences on these indicators were not accounted for by income and insurance coverage.

In 1965, the Medicare program was established to reduce financial barriers to hospital and physician services for persons aged 65 and older. To participate in this program, hospitals had to comply with Title VI of the Civil Rights Act of 1964, which requires that no one be excluded from federal benefits based on race, color, or national origin. This requirement played a large role in desegregating hospitals (Quadagno, 2000).

Medicare has indeed improved the situation for older adults. For instance, Decker and Rapaport (2002) show that turning 65 increases the chances of having a mammogram among black women, particularly uneducated black women. However, there is also evidence that racial differences remain among older adults in access to health services (Gornick, 2000).



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