Uninsured Latino children more likely not to get medical care

Writing in the September issue of Pediatrics, Dr. Flores, one of the country's foremost experts on multicultural health care issues, sought to identify the risk factors for and consequences of being uninsured in Latino children.

Dr. Flores is professor of pediatrics, epidemiology and health policy at the Medical College of Wisconsin and director of the Center for Advancement of Underserved Children at the Medical College and Children's Hospital.

Latinos are the most uninsured racial/ethnic group of children in the United States, with 22 percent (approximately 3 million) of Latino children less than 18 years old having no health insurance coverage in 2005. This compares with uninsured rates of 7.4% among non-Latino white children, 14.5% among African-Americans and 12.4% among Asians/Pacific Islanders.

Previous research has shown that certain factors that have a high prevalence among Latino children and their families also are associated with greater risks of lacking health insurance.

"It was unclear, however, which specific factors are significantly associated with Latino children's lack of insurance. Our study is the first to comprehensively and simultaneously look at a variety of factors, including immigration status, family income, child age, the number of siblings, parental employment status, duration of parental residence in the US, parental educational attainment and marital status," Dr. Flores said.

After interviewing some 900 Latino families drawn from the greater Boston metropolitan area, Dr. Flores and his team found that after adjustment, parental non-citizenship, having two parents work, low family income, and older child age are associated with being an uninsured child, but Latino ethnicity is not. The higher prevalence of other risk factors appears to account for Latino children's high risk of being uninsured. Uninsured Latino children are significantly more likely than insured Latino children to have no regular physician, and to not get needed medical care due to expense, lack of health insurance, difficulty making appointments, and cultural barriers.

"These findings indicate specific high-risk populations that might benefit most from targeted Medicaid and SCHIP (State Children's Health Insurance Program) outreach and enrollment efforts," Dr. Flores says.