Health insurance coverage among foreign-born US residents: the impact of race, ethnicity, and length of residence.

OBJECTIVES/SPECIFIC AIMS: The aim of this study is to examine if stable health insurance coverage is associated with improved type 2 diabetes (DM) control and with reduced racial/ethnic health disparities. METHODS/STUDY POPULATION: We utilized EMR data (2005–2013) from 2 large, urban academic health centers with a racially/ethnically diverse patient population to longitudinally examine insurance coverage, and diabetes outcomes (A1C, LDL cholesterol, BP) and management measures (e.g., A1C and BP monitoring). We categorized insurance stability status during each 6-month interval as 6 separate categories based upon type (private, public, uninsured) and continuity of insurance (continuous, switches, or gaps in coverage). We will examine the association between insurance stability status and DM outcomes adjusting for time, age, sex, comorbidities, site of care, education, and income. Additional analysis will examine if insurance stability moderates the impact of race/ethnicity on DM outcomes. RESULTS/ANTICIPATED RESULTS: Overall, we anticipate that stable health insurance coverage will improve measures for DM care, particularly for racially/ethnically diverse patients. DISCUSSION/SIGNIFICANCE OF IMPACT: The finding of an interaction between insurance stability status and race/ethnicity in improved diabetes management and control would inform the national health care policy debate on the impact of stable health insurance.

Download Full-text

The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender

Health Services Research ◽

10.1111/1475-6773.12711 ◽

2017 ◽

Vol 53 (2) ◽

pp. 1248-1271 ◽

Cited By ~ 39

Author(s):

George L. Wehby ◽

Wei Lyu

Keyword(s):

Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Race Ethnicity ◽

And Gender ◽

Ethnicity And Gender ◽

The Impact ◽

Medicaid Expansions

Download Full-text

The convergence of racial and income disparities in health insurance coverage in the United States

International Journal for Equity in Health ◽

10.1186/s12939-021-01436-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

De-Chih Lee ◽

Hailun Liang ◽

Leiyu Shi

Keyword(s):

Health Insurance ◽

Low Income ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

The United States ◽

Combined Effect ◽

Medical Expenditure ◽

The Us ◽

Race Ethnicity ◽

Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

Download Full-text