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Healthcare Costs: A Challenge for U.S. Minorities

Healthcare Costs: A Challenge for U.S. Minorities

Nearly half of blacks and Hispanics say they struggled at times to pay for medical care in the last year

by Magali Rheault

GALLUP NEWS SERVICE

PRINCETON, NJ -- Over the last few years, the continued rise in health insurance premiums and the decline in the number of Americans covered by health insurance have underscored the public's focus on the issue of healthcare. When Gallup asks about the public's most pressing financial concerns, Americans usually rate healthcare costs as the top problem; in Gallup's most recent polling on the topic, healthcare rates behind only Iraq and immigration when Americans name the top problem facing the country more generally. According to the Kaiser Family Foundation, workers' contributions toward the cost of family health coverage reached $2,973 in 2006, up $1,354 since 2000. Additionally, the Employee Benefit Research Institute (EBRI) reports that 46 million people under the age of 65 had no medical coverage in 2005, up 16% since 2000.

Gallup's annual Minority Rights and Relations survey shows that a significant percentage of Americans -- including almost half of Hispanics and blacks -- report times in the past year when they didn't have enough money to pay for medical expenses, a proportion that has grown significantly over the years.

The June 4-24 survey shows that 32% of Americans were unable to pay for needed healthcare at times during the past year. That is the highest Gallup has found on this measure, first asked in 1976. In that initial survey, just 15% of Americans had difficulty paying for healthcare. During the nearly 20-year period from 1984 to 2002, Gallup found a slightly higher percentage -- ranging from 21% to 25% -- reporting healthcare payment problems. In more recent years, paying for healthcare has been a growing problem, with 28% saying there were times when they were unable to pay for care in the 2004 and 2005 surveys, and an even higher percentage saying so in the latest survey.

Although healthcare costs rose more slowly in 2006 than in any of the past six years, costs still increased more than twice as fast as the rate of inflation and workers' earnings. Also, EBRI reports that 15% of uninsured workers were eligible for health benefits in 2002. However, two-thirds of such workers didn't participate in their employers' health plan because of the cost.

A Challenge for Large Numbers of Minorities

Both blacks and Hispanics are nearly twice as likely as non-Hispanic whites to say paying for healthcare has been difficult. Forty-eight percent of Hispanics, 45% of blacks, and 26% of non-Hispanic whites told Gallup there were times in the past year when they couldn't afford to pay for healthcare. Also, according to the EBRI report, Hispanics are more likely to be uninsured than individuals from other racial or ethnic groups.

Blacks have been more likely than whites to report difficulties in paying for healthcare since Gallup began tracking these differences in 1984, with the gap typically ranging from 15 to 20 points. Hispanics are also more likely than whites to struggle in paying for health expenses. In each of the three years for which Gallup has data, the gap between Hispanics and whites is slightly over 20 points. 

 As expected, lower levels of education and household income are related to an increased likelihood to have trouble paying for healthcare. In the June Gallup Poll, 40% of adults with a high-school education or less say there were times in the past year when they didn't have enough money to pay for healthcare, compared with 19% of adults with a bachelor's degree only. Also, 54% of American adults earning less than $20,000 annually say they struggled to pay for their medical costs, compared with 12% of adults earning at least $75,000.

Bottom Line

Most Americans have healthcare coverage through an employment-based plan. The combination of increased numbers of the uninsured and the sustained rise in healthcare costs spell a worrisome trend. The data reviewed in this report show that a third of all Americans have had times during the past year when they couldn't afford to pay for needed healthcare. Blacks and Hispanics appear to be more affected than whites by the high cost of medical care. Individuals who struggle to pay for healthcare may forego preventive health programs and refrain from seeking medical treatment when they need it most. The financial and emotional stress stemming from the inability to pay for healthcare can also have serious implications for individuals' health and the overall wellbeing of their families.

Survey Methods

Results for this Gallup study are based on telephone interviews with 2,388 national adults, aged 18 and older, conducted June 4-24, 2007, including oversamples of blacks and Hispanics that are weighted to reflect their proportions in the general population. For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±5 percentage points. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For results based on the sample of 868 non-Hispanic whites, the maximum margin of sampling error is ±7 percentage points.

For results based on the sample of 802 blacks, the maximum margin of sampling error is ±6 percentage points.

For results based on the sample of 502 Hispanics, the maximum margin of sampling error is ±6 percentage points (138 out of the 502 interviews with Hispanics were conducted in Spanish).


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