Jinsook Kim, DDS, MPH, Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, PO Box 951772, Los Angeles, CA 90095, 310-737-4774, jinskchs@ucla.edu

BACKGROUND: Immigrant population has been rapidly increasing since 1970 due to a large scale of immigration flows mainly from Asia and Latin America. With the increase of the number of immigrants, concerns have been raised regarding immigrants' use of social welfare services, such as publicly funded health insurance. However, little work exists in the literature to examine whether there are differences in public health insurance coverage between immigrants and others, while accounting for related factors. OBJECTIVES: This study examines health insurance coverage of Californians ages 18 to 64 to determine if immigrants and their children depend on public health insurance more than native citizens of US parentage controlling for covariates, and to identify how factors predict public health insurance of various ethnic and nativity groups. METHOD: This study uses the adult component of the 2001 California Health Interview Survey public use data to compare public health insurance coverage between native citizens of US parentage and first or second generation immigrants. Logistic regression was conducted to estimate the odds ratio (OR) of having public health insurance relative to having employment-based insurance as a function of generation, ethnicity, and employment sector, controlling for health status, sociodemographic characteristics, and acculturation factors. Due to interaction between ethnicity and several predictors, logistic regression with same predictors was performed for each ethnic group to examine how effects of predictors on health insurance coverage varied by ethnicity. RESULTS: Although a higher percentage of immigrants (14.8% of first generation; 11.7% of second generation) had public health insurance than native citizens (10%), the difference disappeared when controlled for covariates. Impacts of predictors on public health insurance differed by ethnicity. Among Latinos, higher education didn’t affect the odds of having public health insurance relative to employment-based health insurance. However, college education compared to high school education significantly decreased the odds ratio of having public health insurance for whites (OR=0.53, p<0.001) and Asian Americans (OR=0.35, p<0.001). Income and employment sector had consistent effects on the outcome in an expected direction across ethnic groups. Employees in small firms were more likely to have public health insurance than individuals in public sector and income level was negatively related to public health insurances. CONCLUSIONS: Immigrants are not more likely to depend on public health insurance than native citizens of US parentage with comparable indicators. The results also show varying effects of predictors on health insurance coverage by ethnicity.

Learning Objectives:

• 1. List three factors that are associated with public health insurance coverage across ethnic groups.
• 2. Articulate the mechanism through which ethnic minority immigrants are not covered by employment-based health insurance.

Keywords: Health Insurance, Immigrants

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.