1. Access to health care among Hispanic/Latino children: U.S., 1998-2001 by: Gulnur Scott, M.P.A. Hanyu Ni, Ph.D. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics

2. Background Access to quality health care is one of the most important determinants of well-being of children Hispanic/Latinos are more likely to lack access to health care than persons of other racial and ethnic groups Few studies have provided national estimates of access to health care by ethnic subgroups of Hispanic/Latino children

3. Objectives To provide recent national estimates of access to health care for subgroups of Hispanic/Latino children To assess ethnic disparity in access to health care among Hispanic/Latino children

4. 1998-2001 National Health Interview Surveys (NHIS) Nationally representative sample Household interview The black and Hispanic/Latino populations are over-sampled Data Source:

5. Target population : Mexican, Mexican-American Central or South American Puerto Rican Cuban/Cuban American Dominican Republic Multiple Hispanic Other Latin or Spanish Hispanic/Latino children aged <18 years Ethnic subgroups

6. Measures of access to health care Health insurance coverage Usual source of health care Unmet medical needs

7. Health insurance coverage Lack of health insurance coverage: Not covered by any kind of health insurance or health care plan at the time of the interview Type of coverage Private Public Medicaid Medicare SCHIP

8. Usual source of care Is there a place that (Sample Child name) usually goes when (he/she) is sick or you need advice about (his/her) health? What kind of place does (Sample Child name) go to most often?

9. Medical care Prescription medication Eye glasses Dental care Mental health care or counseling Could not afford Unmet medical needs Delayed care because of cost

10. Statistical analysis N=14,284 (Hispanic/Latino children) Weighted to reflect national estimates SUDAAN software

11. Ethnic subgroups of Hispanic/Latino children : U.S., 1998-2001 Source: National Health Interview Survey Weighted Percent Mexican Puerto Rican Cuban Central or South American Other Hispanic

12. Place of residence among Hispanic/Latino and NH white children : U.S., 1998-2001 Source: National Health Interview Survey Percent

13. Lack of health insurance coverage among Hispanic/Latino children : U.S., 1998-2001 Source: National Health Interview Survey Percent

14. Data Source: National Health Interview Survey Percent Mexican Puerto Cuban Central/ Other Hispanic NH white Rican South Hispanic American Lack of health insurance coverage by age groups among Hispanic/Latino children: U.S., 1998-2001

15. Data Source: National Health Interview Survey Percent Mexican Puerto Cuban Central/ Other Hispanic NH white Rican South Hispanic American Lack of health insurance coverage by poverty status among Hispanic/Latino children: U.S., 1998-2001 Lack of health insurance coverage by poverty status among Hispanic/Latino children: U.S., 1998-2001

16. Data Source: National Health Interview Survey Percent Mexican Puerto Cuban Central/ Other Hispanic NH white Rican South Hispanic American Lack of health insurance coverage by nativity among Hispanic/Latino children: U.S., 1998-2001 Lack of health insurance coverage by nativity among Hispanic/Latino children: U.S., 1998-2001

17. Public coverage among poor and near poor Hispanic/Latino children: U.S., 1998-2001 Source: National Health Interview Survey Percent

18. Having a usual source of care among Hispanic/Latino children: U.S., 1998-2001 Source: National Health Interview Survey Percent

19. Data Source: National Health Interview Survey Percent Mexican Puerto Cuban Central/ Other Hispanic NH white Rican South Hispanic American Having a usual source of care by poverty status among Hispanic/Latino children: U. S., 1998-2001

20. Data Source: National Health Interview Survey Percent Mexican Puerto Cuban Central/ Other Hispanic NH white Rican South Hispanic American Having a usual source of care by nativity among Hispanic/Latino children: Having a usual source of care by nativity among Hispanic/Latino children: U. S., 1998-2001

21. Usual source of care: U. S., 1998-2001 Hispanic/LatinoNon-Hispanic white Dr. office Clinic or health care Emergency department Other Data Source: National Health Interview Survey

22. Place of routine or preventive care: U.S., 1998-2001 Place of routine or preventive care: U.S., 1998-2001 Hispanic/Latino Non-Hispanic white Dr. officeClinic or health careEmergency department Other Data Source: National Health Interview Survey Doesn’t get routine preventive care

23. Unmet medical needs among Hispanic/Latino children: U.S., 1998-2001 Source: National Health Interview Survey Percent

24. Data Source: National Health Interview Survey Percent Mexican Puerto Cuban Central/ Other Hispanic NH white Rican South Hispanic American Unmet medical needs by nativity among Hispanic/Latino children: U.S., 1998-2001 Unmet medical needs by nativity among Hispanic/Latino children: U.S., 1998-2001

25. Length of time since last contact: U.S., 1998-2001 Length of time since last contact: U.S., 1998-2001 Hispanic/Latino Non-Hispanic white 6 months or lessNeverMore than 6 months More than 1 year Data Source: National Health Interview Survey

26. Summary Poor and near poor Hispanic/Latino children were more likely than poor and near poor NH white children to be covered by a public plan Among poor and near poor Hispanic/Latino children, Mexican children were least likely to be covered by a public plan

27. Summary – cont. Foreign-born Hispanic/Latino children were three times as likely as US-born Hispanic/Latino children to lack health insurance coverage Among the foreign-born ethnic subgroups, Mexican children were most likely to lack health insurance coverage

28. Summary – cont. Hispanic/Latino children were less likely than NH white children to have a usual place to go for medical care The percent of children who had a usual place to go for medical care was lowest among Mexican children

29. Summary – cont. The percent of children experiencing an unmet medical need due to cost was higher for foreign-born Hispanic/Latino children than for U.S.-born Hispanic/Latino children

30. Conclusion There is an ethnic disparity in access to health care among Hispanic/Latino children Mexican children were most likely to lack access to health care

31. Survey Planning and Development Branch For information please contact: www.cdc.gov/nchs/nhis.htm