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APHA Scientific Session and Event Listing

Juan Albertorio-Díaz, NCHS, HYAT Bldg IV Rm 2427, HYATTSVILLe, MD 20782, 301.458.4634, jna8@CDC.GOV and Jill A. Marsteller, PhD, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 433 Hampton House, Baltimore, MD 21205.

Background

To address health disparities issues along the US-Mexico Border, in 2000 the United States-Mexico Border Health Commission (USMBHC) established a 10-year disease prevention and health promotion program, “Healthy Border 2010.” One indicator is the measurement of access to health care among the border population. To this end, estimates of lack of health insurance coverage are needed. However, little research on the border population exists, and statistically reliable estimates of uninsurance for regions smaller than states are quite limited. Moreover, estimates by ethnicity for the border region have been previously unavailable.

Study Design

Four years of the National Health Interview Survey, 2000-2003, were merged to calculate lack of health insurance along the US-Mexico Border. Estimates were stratified by ethnicity and geographic area. In addition, a logistic regression tested the influence of demographic and health-related variables on insurance status among Border residents, with particular attention to ethnic differences.

Findings

Along the US side of the border with Mexico, 22.9% were uninsured and 44.1% of these had lacked coverage for a year or more.

Along the Border, 38.2% of Hispanics were uninsured compared to 12% of Non-Hispanics. At all geographic levels examined, uninsurance was considerably higher for Hispanics. The difference between ethnic groups was larger in the Border States than nationally and larger in the Border counties than in the Border States.

Controlling for other influences, Hispanics at the Border have twice the odds of being uninsured compared to non-Hispanics. Findings also show that males; rural residents; single people; non-citizens; the poor; and the near poor have higher odds of being uninsured.

Conclusions Lack of insurance along the Border is strongly evidenced. Specifically, Border Hispanics are substantially more likely than Hispanics and Non-Hispanics in any other US region examined to lack health insurance at the time of the interview. Further work on insurance coverage is recommended for a better understanding of health care access, disparities, and potential solutions to address the uninsurance issue.

Implication for Policy, Delivery or Practice To address lack of access to health care at the US-Mexico Border, health policies and practices regarding insurance coverage may be considered. To this end, international health policy discussions like those in the USMBHC may assist in uncovering solutions.

Learning Objectives:

• • Quantify the lack of health insurance along the US-Mexico Border
• • Compare uninsurance rates by ethnicity
• • Identify covariates of lack of health insurance on the Border

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 1690.0 kb)