Pediatrics
Volume 118, Issue 3, 2006, Pages e730-e740

Why are Latinos the most uninsured racial/ethnic group of US children? A community-based study of risk factors for and consequences of being an uninsured Latino child (Article)

Flores G.* , Abreu M. , Tomany-Korman S.C.
  • a Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States, Department of Epidemiology, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI, United States, Children's Research Institute, Children's Hospital of Wisconsin, Milwaukee, WI, United States, Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, United States
  • b Boston University School of Public Health, Boston, MA, United States
  • c Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States

Abstract

BACKGROUND. Latinos continue to be the most uninsured racial/ethnic group of US children, but not enough is known about the risk factors for and consequences of not being insured in Latino children. OBJECTIVE. The objective of this study was to identify the risk factors for and consequences of being uninsured in Latino children. METHODS. A cross-sectional survey was conducted of parents at urban, predominantly Latino community sites, including supermarkets, beauty salons, and laundromats. Parents were asked 76 questions on access and health insurance. RESULTS. Interviews were conducted of 1100 parents, 900 of whom were Latino. Uninsured Latino children were significantly more likely than insured Latino children to be older (mean age: 9 vs 7 years) and poor (89% vs 72%) and to have parents who are limited in English proficiency (86% vs 65%), non-US citizens (87% vs 64%), and both employed (35% vs 27%). Uninsured Latinos were significantly less likely than their insured counterparts to have a regular physician (84% vs 99%) and significantly more likely not to be brought in for needed medical care because of expense, lack of insurance, difficulty making appointments, inconvenient office hours, and cultural issues. In multivariable analyses, parents who are undocumented or documented immigrants, both parents working, the child's age, and the $4000 to $9999 and $15 000 to $19 999 family income quintiles were the only factors that were significantly associated with a child's being uninsured; neither Latino ethnicity nor any other of 6 variables were associated with being uninsured. Compared with insured Latino children, uninsured Latino children had 23 times the odds of having no regular physician and were significantly more likely not to be brought in for needed medical care because of expense, lack of health insurance, difficulty making appointments, and cultural barriers. CONCLUSIONS. After adjustment, parental noncitizenship, having 2 parents work, low family income, and older child age are associated with being an uninsured child, but Latino ethnicity is not. The higher prevalence of other risk factors seems to account for Latino children's high risk for being uninsured. Uninsured Latino children are significantly more likely than insured Latino children to have no regular physician and not to get needed medical care because of expense, lack of health insurance, difficulty making appointments, and cultural barriers. These findings indicate specific high-risk populations that might benefit most from targeted Medicaid and State Child Health Insurance Program outreach and enrollment efforts. Copyright © 2006 by the American Academy of Pediatrics.

Author Keywords

Health status Children Medical home Pediatrics Health services research Uninsured Hispanic Americans

Index Keywords

immigrant medically uninsured health survey race difference health insurance human language ability statistics health service priority journal health status Health Surveys Hispanic Americans Cross-Sectional Studies United States income cross-sectional study Humans Hispanic Adolescent parent Infant, Newborn male preschool child female Infant risk factor Risk Factors Child, Preschool newborn Child Welfare cultural factor Article Family Relations human experiment family relation health care access physician Utilization Review child health care Child Health Services ethnicity patient citizenship Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-33749053879&doi=10.1542%2fpeds.2005-2599&partnerID=40&md5=9931d017be41891ddb438d0b8e59b18b

DOI: 10.1542/peds.2005-2599
ISSN: 00314005
Cited by: 49
Original Language: English