Disparities in Access to Care among Latino Subpopulations in Los Angeles County, California

Background: Latinos account for 48% of the total population in Los Angeles County, California, and consist of diverse subgroups. Our study aims to assess disparities in access to health care among adult Latino subpopulations.

Methods: We pooled data from 4 cycles of the Los Angeles County Health Survey (2002, 2005, 2007, & 2011) and categorized Latinos into the following subgroups: Mexicans (sample size: n=8,516), Central Americans (n=1,952), Cubans (n=111), Puerto Ricans (n=151), and South Americans (n=361). To assess access to care, we examined medical and dental insurance coverage, difficulty accessing medical care, and whether respondents could afford various forms of health care when needed. Multivariate Logistic regression was used to further examine disparities among subgroups.

Results: Marked disparities were observed among Latino subgroups. For example, Puerto Ricans, Cubans, and South Americans were more likely to have insurance coverage and less likely to report difficulty accessing medical care than Mexicans. In contrast, Central Americans were less likely than Mexicans to have insurance coverage and more often could not afford needed health care. Notably, some, but not all, of the associations between access to care and the subgroups were reduced or eliminated after controlling for socioeconomic status and language of interview.

Conclusion: By pooling multiple years of data, we were able to assess disparities among Latino subgroups, which otherwise would have been masked by studying Latinos as a whole. Our study revealed that socioeconomic status and language of interview accounted for most of the disparities in access to care among Latino subgroups.