Ponce Ninez A, Cochran Susan D, Mays Vickie M, Chia Jenny, Brown E Richard
Department of Health Services, UCLA School of Public Health, 650 Charles E. Young Drive, Box 951772, Los Angeles, CA 90095-1772, USA.
J Immigr Minor Health. 2008 Apr;10(2):167-76. doi: 10.1007/s10903-007-9059-5.
The health coverage of low-income workers represents an area of continuing disparities in the United States system of health insurance. Using the 2001 California Health Interview Survey, we estimate the effect of low-income wage earners' citizenship and gender on the odds of obtaining primary employment-based health insurance (EBHI), dependent EBHI, public program coverage, and coverage from any source. We find that noncitizen men and women who comprise 40% of California's low-income workforce, share the disadvantage of much lower rates of insurance coverage, compared to naturalized and U.S.-born citizens. However, poor coverage rates of noncitizen men, regardless of permanent residency status, result from the cumulative disadvantage in obtaining dependent EBHI and public insurance. If public policies designed to provide a health care safety net fail to address the health care coverage needs of low-wage noncitizens, health disparities will continue to increase in this group that contributes essentially to the U.S. economy.
在美国医疗保险体系中，低收入劳动者的医保覆盖情况一直存在差异。利用2001年加利福尼亚州健康访谈调查，我们估算了低收入工薪阶层的公民身份和性别对获得基于主要就业的医疗保险（EBHI）、附属EBHI、公共项目覆盖以及任何来源的医保覆盖几率的影响。我们发现，占加利福尼亚州低收入劳动力40%的非公民男性和女性，与入籍公民和美国出生的公民相比，都面临着保险覆盖率低得多的劣势。然而，无论永久居留身份如何，非公民男性的保险覆盖率低，是由于在获得附属EBHI和公共保险方面累积的劣势所致。如果旨在提供医疗安全网的公共政策未能满足低薪非公民的医保覆盖需求，那么在这个对美国经济至关重要的群体中，健康差距将持续扩大。
