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Mexican-Americans Lag in Health Coverage : Insurance: Many are not eligible for government programs and do not get benefits through their jobs.

TIMES MEDICAL WRITER

A greater percentage of Mexican-Americans lacked health insurance in 1988 than blacks, Anglos or other Latinos, according to a new study from the University of Texas Medical Branch in Galveston and the UCLA School of Public Health.

The survey estimated that 37% of Mexican-Americans were uninsured for medical expenses, compared to 20% of Cuban-Americans, 20% of blacks, 16% of Puerto Ricans and 10% of Anglos. About 13% of the entire population lacked health insurance.

The researchers found that Latinos from Mexico were more likely to be employed than other Latinos and blacks. But many had low-paying jobs that did not provide health insurance benefits. The study is being published today in the Journal of the American Medical Assn.

Many Mexican-Americans “are not eligible for government programs but they can’t afford private insurance and they do not get health insurance through their jobs,” said Fernando M. Trevino, a health services researcher at the University of Texas who led the research team.

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Mexican-Americans were significantly less likely than Puerto Ricans and slightly less likely than Cuban-Americans to receive Medicaid, the government insurance program for the poor.

Trevino cited two possible explanations for these differences. First, many Mexican-Americans and Cuban-Americans live in states such as Texas and Florida, with relatively restrictive Medicaid programs. Second, a higher percentage of Mexican-American and Cuban-American families have both parents in the household. Medicaid coverage rules favor households headed by women.

Individuals without health insurance are less likely than individuals with health insurance to have a personal physician or a regular source of medical care. They are also more likely to put off needed medical care, raising the possibility of developing illnesses that are both more serious and more expensive to treat.

Mexican-Americans in particular are likely to have a large number of “undiagnosed health needs . . . because of their limited contact with physicians and their extremely low rate of annual preventive physical examinations,” the study says.

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The research was based on data from a 1989 population survey conducted by the U.S. Bureau of the Census, which included specific questions on family income, health insurance and work experience for the previous year.

Among the uninsured, 53% of Mexican-Americans, 60% of Cuban-Americans and 46% of Puerto Ricans said they were employed; however a higher percentage of Mexican-Americans (53%) said they were living at the poverty level than were members of the other Latino groups.

The health insurance differences among ethnic groups were similar to those Trevino and his colleagues had obtained in prior studies, except that the percentages of uninsured were considerably higher.

For example, over the last decade, the percentage of uninsured has increased from 8.7% to 10.2% among whites, Trevino said. Among Mexican-Americans, it has increased from about 30% to 37%.

AMERICANS WITHOUT MEDICAL INSURANCE

Overall, 13% of the U.S. population was without medical insurance in 1988. Latinos represent the largest group without medical insurance with 32% uninsured.

Racial breakdown for the uninsured.

White: 10%

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Black: 20%

Latino: 32%

Other minority: 18%

Latinos by country of origin.

Mexican-American: 37%

Cuban-Americans: 20%

Puerto Ricans: 16%

Source: Journal of American Medical Assn.

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