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

Figure 0 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 K A I S E R C O K A I S E R C O M M I S S I O N I S S I O N O N O N Medicaid and th edicaid and the Uninsured e Uninsured Figure 1 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.” K A I S E R C O K A I S E R C O M M I S S I O N I S S I O N O N O N Medicaid and th edicaid and the Uninsured e Uninsured 1

Figure 2 Methodology • Data from Community Tracking Study (CTS) household surveys conducted between 1996-2003. – Measures health insurance coverage, access to care, and use of 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) 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 Medicaid and th edicaid and the Uninsured e Uninsured Figure 3 The Hispanic Population by Community, 2003 Number of People in thousands: Growth Between 1996 and 2003 39,460 10,283 19,248 3,565 12,423 29,177 2,975 7,790 15,683 3,745 9,448 4,045 Total U.S. New Growth Major Hispanic Other Areas Communities Centers (5-20% Hispanic (>20% Hispanic (<5% Hispanic in 1996) in 1996) in 1996) K A I S E R C O K A I S E R C O M M I S S I O N I S S I O N O N O N Medicaid and th edicaid and the Uninsured e Uninsured Source: Community Tracking Study household surveys. 2

Figure 4 Changes in Health Insurance Coverage Among Hispanics by Community, 1996-2003 Uninsured Medicare 25% * 31% 30% 32% Medcaid/Other Public Private 7% 6% 9% 8% 12% 15% 13% 19% * 54% * 45% 46% 41% 1996-1999 2000-2003 1996-1999 2000-2003 New Growth Communities Major Hispanic Centers (<5% Hispanic in 1996) (>20% Hispanic in 1996) * denotes change from 1996-1999 period is statistically significant at .05 level. 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 Note: Medicaid includes SCHIP and other state-funded coverage Medicaid and th edicaid and the Uninsured e Uninsured Source: Community Tracking Study household surveys. Figure 5 Change in Annual Family Income by Community, 1996-2003 1996-99 2000-03 * $54,700 $52,500 $51,800 $51,700 $41,000 * $35,000 $34,200 $33,200 All persons Hispanics All persons Hispanics Major Hispanic Centers New Growth Communities (>20% Hispanic in 1996) (<5% Hispanic in 1996) * denotes change from 1996-99 is statistically significant at .05 level K A I S E R C O K A I S E R C O M M I S S I O N I S S I O N O N O N Note: All estimates in 2002 dollars. Medicaid and th edicaid and the Uninsured e Uninsured Source: Community Tracking Study household surveys. 3

Figure 6 Availability of Safety Net Providers for Hispanics by Community, 2000-2003 New Growth Communities Major Hispanic Centers 82% 71% * 50% * 43% Percent Within 5 Miles of a Percent Within 10 Miles of a Community Health Center Safety-Net Hospital * 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 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 from the Bureau of Primary Health Care (HRSA) Uniform Data System and the Medicaid and th edicaid and the Uninsured e Uninsured American Hospital Association Annual Survey. Figure 7 Access to Care for Hispanics by Community, 2000-2003 New Growth Communities Major Hispanic Centers 72% 68% 67% 65% * 22% 17% * 15% 10% Percent with Percent with Percent with Emergency Regular Source of Physician Visit Emergency Department Visits Care Department Visit as a Proportion of All Ambulatory Visits 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 *denotes difference with Major Hispanic Center is statistically significant at .05 level Medicaid and th edicaid and the Uninsured e Uninsured Source: Community Tracking Study household surveys. 4

Figure 8 Changes in Health Insurance Coverage in New Growth Communities by Ethnicity, 1996-2003 Uninsured * 10% 11% Medicare 25% * 31% 16% 16% Medicaid/Other Public 7% 4% 6% Private * 6% 12% 15% * * 68% 66% 54% 45% * 1996-1999 2000-2003 1996-1999 2000-2003 Hispanic White * denotes change from 1996-1999 period is statistically significant at .05 level. 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 Note: Medicaid includes SCHIP and other state-funded coverage Medicaid and th edicaid and the Uninsured e Uninsured Source: Community Tracking Study household surveys. Figure 9 Changes in Access to Care in New Growth Communities, by Ethnicity, 1996-2003 1996-1999 2000-2003 * 89% 88% 77% 73% 25% 20% 18% 18% Hispanic White Hispanic White Percent with Emergency Percent with a Regular Department Visit Source of Care K A I S E R C O K A I S E R C O M M I S S I O N I S S I O N O N O N * denotes change from 1996-1999 period is statistically significant at .05 level. Medicaid and th edicaid and the Uninsured e Uninsured Source: Community Tracking Study household surveys. 5

Figure 10 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. K A I S E R C O K A I S E R C O M M I S S I O N I S S I O N O N O N Medicaid and th edicaid and the Uninsured e Uninsured Figure 11 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. 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 Medicaid and th edicaid and the Uninsured e Uninsured 6