IDEAS home Printed from https://ideas.repec.org/a/kap/poprpr/v36y2017i2d10.1007_s11113-016-9416-y.html
   My bibliography  Save this article

Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage Over the Life-Course

Author

Listed:
  • Heeju Sohn

    (UCLA Fielding School of Public Health)

Abstract

Health insurance coverage varies substantially between racial and ethnic groups in the United States. Compared to non-Hispanic whites, African Americans and people of Hispanic origin had persistently lower insurance coverage rates at all ages. This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. It uses the longitudinal 2008 Panel of the Survey of Income and Program Participation (N = 114,345) to describe age-specific patterns of disparity prior to the Affordable Care Act (ACA). A formal decomposition on increment–decrement life tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups’ greater propensity to lose the insurance that they already have. Uninsured African Americans were faster to gain insurance compared to non-Hispanic whites, but their high rates of insurance loss more than negated this advantage. Disparities from greater rates of loss among minority groups emerge rapidly at the end of childhood and persist throughout adulthood. This is especially true for African Americans and Hispanics, and their relative disadvantages again heighten in their 40s and 50s.

Suggested Citation

  • Heeju Sohn, 2017. "Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage Over the Life-Course," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 36(2), pages 181-201, April.
  • Handle: RePEc:kap:poprpr:v:36:y:2017:i:2:d:10.1007_s11113-016-9416-y
    DOI: 10.1007/s11113-016-9416-y
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s11113-016-9416-y
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1007/s11113-016-9416-y?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. H. Peters & Kosali Simon & Jamie Taber, 2014. "Marital Disruption and Health Insurance," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1397-1421, August.
    2. Mary Jo Bane & David T. Ellwood, 1986. "Slipping into and out of Poverty: The Dynamics of Spells," Journal of Human Resources, University of Wisconsin Press, vol. 21(1), pages 1-23.
    3. Robert W. Fairlie & Rebecca A. London, 2009. "Race, ethnicity, and the dynamics of health insurance coverage," Research in Labor Economics, in: Ethnicity and Labor Market Outcomes, pages 335-373, Emerald Group Publishing Limited.
    4. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    5. Robert Schoen, 1975. "Constructing increment-decrement life tables," Demography, Springer;Population Association of America (PAA), vol. 12(2), pages 313-324, May.
    6. Derek Neal & Armin Rick, 2014. "The Prison Boom and the Lack of Black Progress after Smith and Welch," NBER Working Papers 20283, National Bureau of Economic Research, Inc.
    7. Robert Schoen, 1975. "Erratum to: Constructing Increment-Decrement Life Tables," Demography, Springer;Population Association of America (PAA), vol. 12(3), pages 571-571, August.
    8. H. Elizabeth Peters & Kosali Simon & Jamie Rubenstein Taber, 2014. "Marital Disruption and Health Insurance," NBER Working Papers 20233, National Bureau of Economic Research, Inc.
    9. James Kirby & Toshiko Kaneda, 2010. "Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach," Demography, Springer;Population Association of America (PAA), vol. 47(4), pages 1035-1051, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ayman Oweisi & Moawiah S. Mustafa & Luai S. Mustafa & Alyssa N. Eily & Pura Rodriguez de la Vega & Grettel Castro & Noël C. Barengo, 2022. "The Association between Race/Ethnicity and Cancer Stage at Diagnosis of Bone Malignancies: A Retrospective Cohort Study," IJERPH, MDPI, vol. 19(23), pages 1-9, November.
    2. Farah Kader & Clyde Lanford Smith, 2021. "Participatory Approaches to Addressing Missing COVID-19 Race and Ethnicity Data," IJERPH, MDPI, vol. 18(12), pages 1-11, June.
    3. Samuel R. Friedman & Leslie D. Williams & Ashly E. Jordan & Suzan Walters & David C. Perlman & Pedro Mateu-Gelabert & Georgios K. Nikolopoulos & Maria R. Khan & Emmanuel Peprah & Jerel Ezell, 2022. "Toward a Theory of the Underpinnings and Vulnerabilities of Structural Racism: Looking Upstream from Disease Inequities among People Who Use Drugs," IJERPH, MDPI, vol. 19(12), pages 1-19, June.
    4. Gigi R. Kerber & Nicolo P. Pinchak, 2022. "Consistency of Health Insurance Coverage and Women’s Reproductive Healthcare Access During Early Adulthood," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(3), pages 825-842, June.
    5. Matthew Lee Smith & Caroline D. Bergeron & Ledric D. Sherman & Kirby Goidel & Ashley L. Merianos, 2022. "Contextualizing the Chronic Care Model among Non-Hispanic Black and Hispanic Men with Chronic Conditions," IJERPH, MDPI, vol. 19(6), pages 1-18, March.
    6. Jill Furzer & Boriana Miloucheva, 2020. "The Long Arm of the Clean Air Act: Pollution Abatement and COVID-19 Racial Disparities," Working Papers tecipa-668, University of Toronto, Department of Economics.
    7. Engstrom, Curtiss W. & West, Brady T. & Schepis, Ty S. & McCabe, Sean Esteban, 2024. "Does the approach used to measure sexual identity affect estimates of health disparities differently by race? A randomized experiment from the National Survey of Family Growth," Social Science & Medicine, Elsevier, vol. 350(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Robert Schoen, 2020. "Dynamic Multistate Models With Constant Cross-Product Ratios: Applications to Poverty Status," Demography, Springer;Population Association of America (PAA), vol. 57(2), pages 779-797, April.
    2. Jim P Stimpson & Jessie Kemmick Pintor & Fernando A Wilson, 2019. "Association of Medicaid expansion with health insurance coverage by marital status and sex," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-12, October.
    3. Xian Liu & Jersey Liang & Edward Jow-Ching Tu & Nancy Whitelaw, 1997. "Modeling Multidimensional Transitions in Health Care," Sociological Methods & Research, , vol. 25(3), pages 284-317, February.
    4. Clara E. Piano & Rachael Behr & Kacey Reeves West, 2024. "The supply and demand of marital contracts: the case of same-sex marriage," Public Choice, Springer, vol. 198(3), pages 237-268, March.
    5. Margaret E. Blume-Kohout, 2024. "Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act," ILR Review, Cornell University, ILR School, vol. 77(2), pages 199-226, March.
    6. Gigi R. Kerber & Nicolo P. Pinchak, 2022. "Consistency of Health Insurance Coverage and Women’s Reproductive Healthcare Access During Early Adulthood," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(3), pages 825-842, June.
    7. Yiyue Huangfu, 2024. "Return Migration of Rural-Urban Migrant Children in China," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 43(3), pages 1-27, June.
    8. Alice Zulkarnain & Sanders Korenman, 2019. "Divorce and health in middle and older ages," Review of Economics of the Household, Springer, vol. 17(4), pages 1081-1106, December.
    9. J Matthew Hampton & Otto Lenhart, 2019. "'Til insurance do us part: the effect of the affordable care act preexisting conditions provision on marriage," Working Papers 1902, University of Strathclyde Business School, Department of Economics.
    10. Sojung Lim, 2019. "Mothers’ Nonstandard Employment, Family Structure, and Children’s Health Insurance Coverage," Journal of Family and Economic Issues, Springer, vol. 40(2), pages 148-164, June.
    11. Danya Lagos, 2018. "Looking at Population Health Beyond “Male” and “Female”: Implications of Transgender Identity and Gender Nonconformity for Population Health," Demography, Springer;Population Association of America (PAA), vol. 55(6), pages 2097-2117, December.
    12. Matt Hampton & Otto Lenhart, 2019. "The effect of the Affordable Care Act preexisting conditions provision on marriage," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1345-1355, November.
    13. Kenneth Couch & Christopher Tamborini & Gayle Reznik, 2015. "The Long-Term Health Implications of Marital Disruption: Divorce, Work Limits, and Social Security Disability Benefits Among Men," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1487-1512, October.
    14. Jack DeWaard & Jasmine Trang Ha & James Raymer & Arkadiusz Wiśniowski, 2017. "Migration from New-Accession Countries and Duration Expectancy in the EU-15: 2002–2008," European Journal of Population, Springer;European Association for Population Studies, vol. 33(1), pages 33-53, February.
    15. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    16. Pat Doyle & Carole Trippe, "undated". "Improving the Income Allocation Procedures in MATH," Mathematica Policy Research Reports 4b99f4a1d712469db87228716, Mathematica Policy Research.
    17. Gordon Dahl, 2010. "Early teen marriage and future poverty," Demography, Springer;Population Association of America (PAA), vol. 47(3), pages 689-718, August.
    18. Francesco Devicienti & Valentina Gualtieri & Mariacristina Rossi, 2014. "The Persistence Of Income Poverty And Lifestyle Deprivation: Evidence From Italy," Bulletin of Economic Research, Wiley Blackwell, vol. 66(3), pages 246-278, July.
    19. Zachary Van Winkle & Emanuela Struffolino, 2018. "When working isn’t enough: Family demographic processes and in-work poverty across the life course in the United States," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 39(12), pages 365-380.
    20. Steven Raphael, 2014. "The New Scarlet Letter? Negotiating the U.S. Labor Market with a Criminal Record," Books from Upjohn Press, W.E. Upjohn Institute for Employment Research, number nsc, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:poprpr:v:36:y:2017:i:2:d:10.1007_s11113-016-9416-y. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.