Disparities in Health and Health Insurance by Race, Ethnicity, and Sex on the Eve of Health Care Reform: Using Life Table Measures as Benchmarks for Progress

Toshiko Kaneda, Population Reference Bureau (PRB)
James B. Kirby, Agency for Healthcare Research and Quality (AHRQ), DHHS

Considering health insurance coverage in the context of health status throughout the life course is critical for understanding the magnitude of racial/ethnic disparities in health care in the United States. In this study, we use life table techniques to compare health- and insurance-specific life expectancies across Hispanics, non-Hispanic Blacks, and non-Hispanic Whites. We find that Hispanics live 23 years without health insurance over a typical life time compared to 13 years for non-Hispanic Blacks and nine years for non-Hispanic Whites. Furthermore, Hispanics spend disproportionately more of their uninsured years in unhealthy state with potentially high medical need—-10 years compared to four years for non-Hispanic Whites and six years for non-Hispanic Blacks. Analysis by sex further reveals important racial/ethnic differences. While men, on average, spend more years uninsured than women across all racial/ethnic groups, the male disadvantage is significantly larger among non-Hispanic Blacks compared to others.