UCLA School of Public Health, 650 Charles E. Young Drive South Room 31-299C, Box 951772, Los Angeles, CA, 90095, USA.
J Gen Intern Med. 2009 Nov;24 Suppl 3(Suppl 3):561-6. doi: 10.1007/s11606-009-1069-7.
We sought to determine the differences in observed and unobserved factors affecting rates of health insurance coverage between US Latino adults and US Latino adults of Mexican ancestry. Our hypothesis was that Latinos of Mexican ancestry have worse health insurance coverage than their non-Mexican Latino counterparts.
The National Health Interview Survey (NHIS) database from 1999-2007 consists of 33,847 Latinos. We compared Latinos of Mexican ancestry to non-Mexican Latinos in the initial descriptive analysis of health insurance coverage. Disparities in health insurance coverage across Latino categories were later analyzed in a multivariable logistic regression framework, which adjusts for confounding variables. The Blinder-Oaxaca technique was applied to parse out differences in health insurance coverage into observed and unobserved components.
US Latinos of Mexican ancestry consistently had lower rates of health insurance coverage than did US non-Mexican Latinos. Approximately 65% of these disparities can be attributed to differences in observed characteristics of the Mexican ancestry population in the US (e.g., age, sex, income, employment status, education, citizenship, language and health condition). The remaining disparities may be attributed to unobserved heterogeneity that may include unobserved employment-related information (e.g., type of employment and firm size) and behavioral and idiosyncratic factors (e.g., risk aversion and cultural differences).
This study confirmed that Latinos of Mexican ancestry were less likely to have health insurance than were non-Mexican Latinos. Moreover, while differences in observed socioeconomic and demographic factors accounted for most of these disparities, the share of unobserved heterogeneity accounted for 35% of these differences.
我们旨在确定影响美国拉丁裔成年人和具有墨西哥血统的美国拉丁裔成年人健康保险覆盖范围的观察因素和未观察因素之间的差异。我们的假设是，具有墨西哥血统的拉丁裔的健康保险覆盖范围比非墨西哥裔拉丁裔差。
1999-2007 年的国家健康访谈调查（NHIS）数据库包括 33847 名拉丁裔成年人。在对健康保险覆盖范围进行初始描述性分析时，我们将具有墨西哥血统的拉丁裔与非墨西哥裔拉丁裔进行了比较。在多变量逻辑回归框架中，后来分析了拉丁裔人群中健康保险覆盖范围的差异，该框架调整了混杂变量。应用 Blinder-Oaxaca 技术将健康保险覆盖范围的差异分解为观察和未观察的组成部分。
具有墨西哥血统的美国拉丁裔成年人的健康保险覆盖范围始终低于非墨西哥裔拉丁裔成年人。这些差异中约有 65%可归因于美国具有墨西哥血统人群的观察特征差异（例如年龄、性别、收入、就业状况、教育程度、公民身份、语言和健康状况）。其余差异可能归因于未观察到的异质性，其中可能包括未观察到的与就业相关的信息（例如，就业类型和公司规模）以及行为和特质因素（例如，风险厌恶和文化差异）。
本研究证实，具有墨西哥血统的拉丁裔比非墨西哥裔拉丁裔更不可能拥有健康保险。此外，虽然观察到的社会经济和人口因素差异解释了这些差异的大部分，但未观察到的异质性差异解释了其中的 35%。
