Changes in Health Insurance Coverage and Health Status: Adults

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Public health insurance coverage of adults rose by about one percentage point between 1997 and 2002 (Table 2). Despite this gain, the proportion of adults without health insurance was 17.0 in each year. Hispanic adults did not share in the overall increase in public coverage and were the only group to experience a decline in employer-sponsored health insurance. Consequently, uninsurance among Hispanic adults rose by four percentage points between 1997 and 2002, pushing their already high uninsurance rate to 40.7%.

Medicaid expansions during this period affected both low-income and higher-income adults. Public coverage increased by three percentage points among low-income whites while remaining stable among low-income Hispanics. Low-income blacks saw an increase of four percentage points, but this change was not statistically significant. The proportion of higher-income adults with public health coverage increased among blacks, Hispanics and whites but remained small for each group. kamagra oral jelly 100mg

Table 2. Adults’ Health by Race, Ethnicity and Income, 1997-2002

Variables	1997	Black 2002	Hispanic 1997    2002		White 1997   2002		All 1997   2002
Health Insurance Coverage
All incomes
Employer-sponsored	62.5	62.6	50.9	46.8*	75.9	75.4	71.0	70.2
Medicaid/SCHIP	10.6	72.5*	8.5	8.9	3.7	4.3*	5.1	5.9*
Other	5.2	4.9	4.1	3.7	7.5	7.9	6.9	6.9
Uninsured	27.7	20.0	36.5	40.7*	13.0	12.4	17.0	17.0
Low income
Employer-sponsored	34.5	33.4	28.8	25.5	43.4	43.2	38.1	37.0
Medicaid/SCHIP	23.9	27.9	14.1	14.5	13.3	16.5*	15.3	17.8*
Other	7.3	6.5	4.4	3.6	12.1	11.2	9.7	8.5*
Uninsured	34.3	32.3	52.7	56.4	31.2	29.2	36.9	36.8
Higher income
Employer-sponsored	81.8	80.0	77.4	67.8*	85.5	83.3*	84.5	81.6*
Medicaid/SCHIP	1.5	3.4*	1.9	3.3*	0.8	1.4*	0.9	1.8*
Other	3.8	3.9	3.7	3.9	6.1	7.1*	5.8	6.4
Uninsured	12.9	72.7	17.1	25.1*	7.6	8.3	8.9	10.3*
Health Status
Fair or poor
All incomes	76.0	77.7	23.8	25.0	9.9	10.7	12.2	13.3*
Low income	25.2	29.2	32.9	33.5	20.0	22.2	23.3	25.9*
Higher income	9.6	9.9	13.0	16.7*	6.9	7.9*	7.7	9.0*
Size of Sample (Nj	6,612	5,524	5,786	6,366	41,852	35,770	56,199 49,466
Sources: 1997 and 2002 National Survey of America’s Families Notes: “Black” and “white” include non-Hispanics only; “Hispanic” includes all races. “AH” includes American Indian/Alaska Native, Asian/Pacific Islander, black, Hispanic, and white. Adults are 18-64. Bold indicates that black or Hispanic estimate is significantly different from the estimate for whites at the 0.05 level. Italics indicate that black estimate is significantly different from the estimate for Hispanics at the 0.05 level. Estimates for 1997 use new weights based on the 2000 Census and may differ from previously published estimates using weights based on the 1990 Census. * Difference from 1997 is significant at the 0.05 level.

Patterns of change in uninsurance varied by race and ethnicity. Black and white adults in both income groups saw no change in their uninsurance rates between 1997 and 2002. However, uninsurance increased among higher-income Hispanic adults, from 17.1% to 25.1%. Higher-income Hispanic adults also saw a decline in employer-sponsored insurance during this period. The increase in public coverage was not large enough to compensate for the decline, leaving higher-income Hispanic adults with lower rates of health insurance coverage. Higher-income white adults also experienced a significant decline in employer-sponsored insurance over this period, but unlike Hispanics, they did not see a corresponding increase in uninsurance.
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NS AF respondents were asked whether they considered their health and the health of their spouse or partner to be excellent, very good, good, fair or poor. The share of higher-income Hispanic adults in fair or poor health increased from 13.0% to 16.7%. The share of higher-income white adults in fair or poor health also rose from 6.9% to 7.9%.

Ethnic and racial disparities in adults’ health insurance coverage and health status are roughly similar to those for children, with Hispanics more likely to be uninsured than blacks, and blacks more likely to be uninsured than whites. Data show that 40.7% of Hispanic adults were uninsured in 2002, compared with 20.0% of black adults and 12.4% of white adults. Less than half of all Hispanic adults had employer-sponsored coverage in 2002, while three-quarters of white adults and three-fifths of black adults had such coverage. Similarly, the reported health status of blacks is better than that of Hispanics, and the reported health status of whites is better than that of blacks. In 2002, 25% of Hispanics, 17.1% of blacks, and 10.7% of whites reported being in fair or poor health. As with children, use of respondent reporting may result in different estimates of Hispanic health status than more objective measures would suggest.
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Hispanic adults, like Hispanic children, are disproportionately at risk of being both uninsured and in fair or poor health. In 2002, 6.6 million nonelderly adults were both uninsured and in fair or poor health. Of this number, 44.5% were Hispanic, yet Hispanics accounted for only 12.9% of the national nonelderly adult population, according to the 2002 NSAF. Blacks made up 11.9% of the U.S. adult population, while accounting for 14.7% of the nonelderly adults who were both uninsured and in fair or poor health.