Factors associated with health insurance coverage and health insurance knowledge among Congolese immigrants and African Americans in Illinois

Background:  The disproportionately high rates of adverse health outcomes among the African American community represent an important issue in the United States (DHHS, 2011). Moreover, previous research has shown substantial racial disparities in US health insurance status due to various factors such as unemployment, lack of education, and poverty. However, the role of immigrant status within the Black community in understanding such disparities has not been well studied.

Methods: The purpose of this study was to assess factors associated with health insurance status and health insurance knowledge among Congolese immigrants in a micro-urban area of the Midwest.  A cross-sectional survey sample of a community based sample was conducted among Black residents (Congolese immigrants and African Americans.) Information on demographics and health insurance factors were collected. A total sample size of 109 people was obtained.  Fifty-five Congolese (30 males and 25 females) and fifty-four African Americans (24 males and 30 females) were recruited. 

Results: For the Congolese respondents, limited English proficiency, high premiums, and lack of knowledge of the health care system (p<0.01) were identified as barriers to health care access among Congolese respondents. For African American respondents, high premiums and lack of knowledge also proved to be barriers to health insurance status.

Conclusions:  The results of this study highlight the importance of understanding the heterogeneity of Black community. Understanding how ethnicity affects health behaviors such as health insurance coverage remains a topic for further research.