Study Goals Examine growth of Hispanic population by geographic - - PDF document

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Health Coverage and Access to Care for Hispanics in “New Growth Communities” and “Major Hispanic Centers”

Peter Cunningham, Ph.D. Reporter Briefing September 21, 2006

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Study Goals

• Examine growth of Hispanic population by

geographic location.

• Compare health insurance coverage and

access to care for Hispanics living in “new growth communities” with those living in “major Hispanic centers.”

• Compare coverage and access to care for

Hispanics with non-Hispanic whites in “new growth communities.”

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Methodology

• Data from Community Tracking Study (CTS) household

surveys conducted between 1996-2003.

– Measures health insurance coverage, access to care, and use

• f care

– Representative for the U.S. population and 60 randomly selected communities in 34 states and DC

• 60 CTS communities classified based on percent of

population that was Hispanic in the 1996 survey round.

– “Major Hispanic Centers” had more than 20% Hispanic (e.g., Miami, Los Angeles, Houston, New York) – “New Growth Communities” had less than 5% Hispanic (e.g., Knoxville, Columbus, Greenville, Syracuse)

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29,177 4,045 15,683 9,448 10,283 3,745 3,565 2,975

Total U.S. New Growth Communities Major Hispanic Centers Other Areas

Growth Between 1996 and 2003 39,460 19,248 12,423 7,790

The Hispanic Population by Community, 2003

Source: Community Tracking Study household surveys.

Number of People in thousands:

(5-20% Hispanic in 1996) (<5% Hispanic in 1996) (>20% Hispanic in 1996)

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54% 45% 46% 41% 12% 15% 13% 19% 7% 6% 8% 9% 25% 31% 32% 30% 1996-1999 2000-2003 1996-1999 2000-2003

Uninsured Medicare Medcaid/Other Public Private

New Growth Communities (<5% Hispanic in 1996) Major Hispanic Centers (>20% Hispanic in 1996)

Changes in Health Insurance Coverage Among Hispanics by Community, 1996-2003

* denotes change from 1996-1999 period is statistically significant at .05 level. Note: Medicaid includes SCHIP and other state-funded coverage Source: Community Tracking Study household surveys.

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Major Hispanic Centers (>20% Hispanic in 1996) New Growth Communities (<5% Hispanic in 1996) $52,500 $41,000 $51,800 $34,200 $54,700 $35,000 $51,700 $33,200 All persons Hispanics All persons Hispanics 1996-99 2000-03

Change in Annual Family Income by Community, 1996-2003

* denotes change from 1996-99 is statistically significant at .05 level Note: All estimates in 2002 dollars. Source: Community Tracking Study household surveys.

* *

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Availability of Safety Net Providers for Hispanics by Community, 2000-2003

43% 50% 71% 82% Percent Within 5 Miles of a Community Health Center Percent Within 10 Miles of a Safety-Net Hospital New Growth Communities Major Hispanic Centers * *

* denotes difference from Major Hispanic Centers is statistically significant at .05 level. Note: Safety-net hospitals defined as all public hospitals, as well as private non-profit hospitals that treat a high proportion of Medicaid patients. Sources: Data from the Community Tracking Study household surveys linked to data from the Bureau of Primary Health Care (HRSA) Uniform Data System and the American Hospital Association Annual Survey. K A I S E K A I S E R C O R C O M M I S S I O N I S S I O N O N O N

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Access to Care for Hispanics by Community, 2000-2003

68% 65% 22% 15% 72% 67% 17% 10%

Percent with Regular Source of Care Percent with Physician Visit Percent with Emergency Department Visit Emergency Department Visits as a Proportion of All Ambulatory Visits

New Growth Communities Major Hispanic Centers * *

*denotes difference with Major Hispanic Center is statistically significant at .05 level Source: Community Tracking Study household surveys.

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54% 45% 68% 66% 12% 15% 4% 6% 7% 6% 16% 16% 25% 31% 11% 10% 1996-1999 2000-2003 1996-1999 2000-2003

Uninsured Medicare Medicaid/Other Public Private

Hispanic White

Changes in Health Insurance Coverage in New Growth Communities by Ethnicity, 1996-2003

* * * * * *

* denotes change from 1996-1999 period is statistically significant at .05 level. Note: Medicaid includes SCHIP and other state-funded coverage Source: Community Tracking Study household surveys. K A I S E K A I S E R C O R C O M M I S S I O N I S S I O N O N O N

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Changes in Access to Care in New Growth Communities, by Ethnicity, 1996-2003

77% 88% 20% 18% 73% 89% 25% 18% Hispanic White Hispanic White 1996-1999 2000-2003 * Percent with a Regular Source of Care Percent with Emergency Department Visit

* denotes change from 1996-1999 period is statistically significant at .05 level. Source: Community Tracking Study household surveys.

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Review of Major Findings

• The Hispanic population nearly doubled in new growth

communities but still represented less than 5% of the total population in these areas.

• The uninsured rate for Hispanics in new growth

communities increased over time to about the same level as in major Hispanic centers, driven by a fall off in private coverage.

• Hispanics in new growth communities were less likely to

live near a safety-net provider and more likely to use the emergency room than those in major Hispanic centers.

• The uninsured rate for whites in new growth communities

did not change over time, and they experienced slight improvements in some measures of access.

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Implications

• Hispanics face greater barriers to care than other groups

due to high uninsured rates and language and cultural barriers.

• Communities experiencing the largest growth in their

Hispanic population have little experience caring for a diverse population.

• As the Hispanic population grows in new areas, more

communities may need to develop strategies to address the coverage and access challenges faced by Hispanics.