Abstract
Introduction: In the United States, Latinos have poorer access to and utilization of health care than non-Latino whites. The Patient Protection and Affordable Care Act (ACA) may reduce these disparities. The ACA's impact among Latino subgroups is unknown. Methods: Using the 2011 to 2015 National Health Interview Survey, we examined access to and utilization of health care by Latino subgroups (18-64 years old). Subgroups were defined by Latino heritage group, citizenship status, and language use. Measures of access and utilization included insurance status, delaying medical care, forgoing medical care, visiting the emergency department, and visiting a physician. Logistic regression models were used to estimate the odds of the outcomes. Time period and subgroup interaction terms were used to test the effects of the ACA. Results: Mexicans and Central Americans had lower odds of being insured than did non-Latino whites. After ACA implementation, most reductions in disparities occurred between Puerto Ricans and non-Latino whites. Limited impact of the ACA was observed by language and citizenship status. Conclusions: The ACA has reduced gaps in access to and utilization of health care for some Latino population subgroups. Remaining disparities necessitate policy solutions that move beyond the ACA, particularly for groups excluded from coverage options, such as noncitizens.
Original language | English (US) |
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Pages (from-to) | 52-62 |
Number of pages | 11 |
Journal | Journal of the American Board of Family Medicine |
Volume | 30 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2017 |
Externally published | Yes |
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Keywords
- Emergency Service
- Hispanic Americans
- Hospital
- Insurance Coverage
- Language
- Logistic Models
- Patient Protection and Affordable Care Act
- Surveys and Questionnaires
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Family Practice
Cite this
Impact of the affordable care act on health care access and utilization among latinos. / Alcala, Hector E.; Chen, Jie; Langellier, Brent A; Roby, Dylan H.; Ortega, Alexander N.
In: Journal of the American Board of Family Medicine, Vol. 30, No. 1, 01.01.2017, p. 52-62.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Impact of the affordable care act on health care access and utilization among latinos
AU - Alcala, Hector E.
AU - Chen, Jie
AU - Langellier, Brent A
AU - Roby, Dylan H.
AU - Ortega, Alexander N.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Introduction: In the United States, Latinos have poorer access to and utilization of health care than non-Latino whites. The Patient Protection and Affordable Care Act (ACA) may reduce these disparities. The ACA's impact among Latino subgroups is unknown. Methods: Using the 2011 to 2015 National Health Interview Survey, we examined access to and utilization of health care by Latino subgroups (18-64 years old). Subgroups were defined by Latino heritage group, citizenship status, and language use. Measures of access and utilization included insurance status, delaying medical care, forgoing medical care, visiting the emergency department, and visiting a physician. Logistic regression models were used to estimate the odds of the outcomes. Time period and subgroup interaction terms were used to test the effects of the ACA. Results: Mexicans and Central Americans had lower odds of being insured than did non-Latino whites. After ACA implementation, most reductions in disparities occurred between Puerto Ricans and non-Latino whites. Limited impact of the ACA was observed by language and citizenship status. Conclusions: The ACA has reduced gaps in access to and utilization of health care for some Latino population subgroups. Remaining disparities necessitate policy solutions that move beyond the ACA, particularly for groups excluded from coverage options, such as noncitizens.
AB - Introduction: In the United States, Latinos have poorer access to and utilization of health care than non-Latino whites. The Patient Protection and Affordable Care Act (ACA) may reduce these disparities. The ACA's impact among Latino subgroups is unknown. Methods: Using the 2011 to 2015 National Health Interview Survey, we examined access to and utilization of health care by Latino subgroups (18-64 years old). Subgroups were defined by Latino heritage group, citizenship status, and language use. Measures of access and utilization included insurance status, delaying medical care, forgoing medical care, visiting the emergency department, and visiting a physician. Logistic regression models were used to estimate the odds of the outcomes. Time period and subgroup interaction terms were used to test the effects of the ACA. Results: Mexicans and Central Americans had lower odds of being insured than did non-Latino whites. After ACA implementation, most reductions in disparities occurred between Puerto Ricans and non-Latino whites. Limited impact of the ACA was observed by language and citizenship status. Conclusions: The ACA has reduced gaps in access to and utilization of health care for some Latino population subgroups. Remaining disparities necessitate policy solutions that move beyond the ACA, particularly for groups excluded from coverage options, such as noncitizens.
KW - Emergency Service
KW - Hispanic Americans
KW - Hospital
KW - Insurance Coverage
KW - Language
KW - Logistic Models
KW - Patient Protection and Affordable Care Act
KW - Surveys and Questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85011582730&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85011582730&partnerID=8YFLogxK
U2 - 10.3122/jabfm.2017.01.160208
DO - 10.3122/jabfm.2017.01.160208
M3 - Review article
C2 - 28062817
AN - SCOPUS:85011582730
VL - 30
SP - 52
EP - 62
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
SN - 1557-2625
IS - 1
ER -