Disparities in Health Insurance and Delayed Care Among Hispanic Immigrants in the United States.

backgroundHispanic immigrants in the United States face persistent barriers to healthcare, including lower rates of insurance coverage and a greater likelihood of delaying care due to cost. Clarifying the independent effects of ethnicity and nativity on these disparities is essential to inform effective policy.

methodsWe analyzed pooled data from the 2019-2023 National Health Interview Survey (NHIS), accessed through the Integrated Public Use Microdata Series (IPUMS). Primary outcomes were being uninsured and delayed medical care due to cost in the past 12 months. Key independent variables were Hispanic ethnicity and nativity (US-born vs. foreign-born). Covariates included survey year, age, sex, educational attainment, and family income relative to the federal poverty threshold. Insurance status was also included in the delayed care model. We used multivariable logistic regression with survey weights and design variables to estimate adjusted associations.

resultsBoth Hispanic ethnicity and foreign-born status were significantly associated with higher odds of being uninsured, even after adjusting for demographic and socioeconomic factors. In the delayed care model, lack of insurance was the strongest predictor; however, Hispanic ethnicity and foreign-born status remained independently associated with increased risk. Higher education and a greater income-to-poverty ratio were protective in both models. Despite modest reductions in overall uninsurance and cost-related delays from 2019 to 2023, disparities persisted.

conclusionHispanic immigrants continue to face disproportionate challenges in healthcare access, including higher uninsurance rates and cost-related care delays. While insurance status is a key determinant, disparities remain even after accounting for socioeconomic factors. Policies aimed at expanding affordable coverage and addressing systemic barriers to care for immigrant populations are needed.