One-third of immigrant children, many foreign-born adults in N.J. lack health coverage

One-third of immigrant children and more than 70 percent of foreign-born, nonelderly adults living in New Jersey five years or less lack health coverage, a Rutgers statewide survey finds.

The report, "Health, Coverage and Access to Care of New Jersey Immigrants," by the Rutgers Center for State Health Policy (CSHP), also concludes immigrants face significant access-to-care barriers and their lack of health insurance is a much larger problem than for New Jerseyans born in the United States.

The research describes the health profile, insurance status and health care utilization indicators of New Jersey's diverse immigrant population. The 2009 New Jersey Family Health Survey, a representative survey of 2,500 households designed and conducted by CSHP, describes the demographic and socioeconomic characteristics of the state's approximately 1.7 million immigrants who are predominantly of Asian and Hispanic origin and largely of working age.

Among other findings:

• Non-Hispanic black and Hispanic immigrant adults are disproportionately uninsured.
• Asian and non-Hispanic white immigrant adults lack health insurance at nearly the same rates, but more than three-quarters of Hispanic noncitizens lack health coverage.
• More than one in five foreign-born children and one in three noncitizen adults do not have a usual source of health care.
• Immigrant adults and seniors with a health problem are less likely to have seen a doctor in the past year than those who are U.S.-born.
• In spite of coverage and access barriers, New Jersey immigrants do not use emergency departments for nonurgent health care more than U.S.-born state residents.
• Immigrants in the state are more likely to view accessing care at public or free clinics acceptable.

"Immigrants in New Jersey span the socioeconomic spectrum. Our data show that, in fact, a greater proportion of foreign-born citizen adults have a college degree and are working full time than U.S.-born adults," said Kristen Lloyd, CSHP research analyst and lead author of the report. "On the other hand, noncitizen adults and children who live with them do have lower family incomes than children in entirely U.S.-born families."

Consistent with other studies of the foreign-born, the report also reveals complexity in measures of health status. Immigrants of all ages, but particularly noncitizen adults, report having fewer chronic conditions, such as diabetes and asthma, than their American-born counterparts. Yet, one-third of noncitizens in the U.S. for less than five years consider their general health fair or poor, and nearly half (47 percent) of recent noncitizen immigrant adults say their dental health is fair or poor.

Professor Joel Cantor, CSHP director and co-author of the report, observed, "The new national health reform law, the Affordable Care Act, should increase the number of immigrants in New Jersey with health coverage, thereby improving their access to needed health care. But that is not the end of the story. Many immigrants will remain uninsured, and there will be continuing high demands on safety net health centers and hospitals to provide culturally and linguistically appropriate care."