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Understanding Observed and Unobserved Health Care Access and Utilization Disparities Among U.S. Latino Adults

University of California, Los Angeles, avb{at}ucla.edu

Hai Fang

University of Colorado, Denver

John A. Rizzo

Stony Brook University, New York

Alexander N. Ortega

University of California, Los Angeles

This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder—Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.

Key Words: health care access and utilization • heterogeneity among Latinos • decomposition model • health care disparities

This version was published on October 1, 2009

Medical Care Research and Review, Vol. 66, No. 5, 561-577 (2009)
DOI: 10.1177/1077558709338487


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