Table 2. Medicare Eligibility Age-Related Discontinuities in Racial and Ethnic Disparities in Coverage, Access, and Health.
| Characteristic | White individuals | Black individuals | Hispanic individuals | Disparity | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Expected meana | Adjusted discontinuity (95% CI)b | Expected meana | Adjusted discontinuity (95% CI)b | Expected meana | Adjusted discontinuity (95% CI)b | White and Black individuals | White and Hispanic individuals | |||||
| Expected disparityc | Adjusted discontinuity in disparity (95% CI)b | P valued | Expected disparityc | Adjusted discontinuity in disparity (95% CI)b | P valued | |||||||
| Insurance coverage, % | 92.0 | 6.5 (6.1 to 7.0) | 86.3 | 9.5 (7.6 to 11.4) | 77.4 | 13.9 (12.0 to 15.8) | 5.7 | −3.0 (−5.1 to −0.9) | .003 (.01) | 14.6 | −7.4 (−9.5 to −5.3) | <.001 (<.001) |
| Health care access, % | ||||||||||||
| Have a usual source of care | 92.2 | 1.3 (0.8 to 1.8) | 91.0 | 2.5 (0.8 to 4.3) | 81.7 | 4.4 (1.5 to 7.2) | 1.2 | −1.2 (−3.2 to 0.7) | .24 (.38) | 10.5 | −3.0 (−6.1 to 0.0) | .05 (.09) |
| Unable to see physician in past year because of cost | 8.1 | −3.0 (−3.5 to −2.5) | 13.9 | −4.5 (−6.6 to −2.4) | 19.5 | −7.5 (−9.4 to −5.6) | −5.8 | 1.5 (−0.8 to 3.8) | .22 (.38) | −11.4 | 4.5 (2.4 to 6.7) | <.001 (<.001) |
| Received an influenza vaccination in past year | 53.5 | 2.2 (1.3 to 3.0) | 42.5 | 2.8 (0.8 to 4.9) | 45.4 | 7.0 (3.7 to 10.3) | 11.0 | −0.7 (−3.1 to 1.7) | .60 (.78) | 8.1 | −4.8 (−8.4 to −1.3) | .007 (.01) |
| Health | ||||||||||||
| Self-reported health, % | ||||||||||||
| Poor | 5.8 | −0.2 (−0.7 to 0.3) | 10.3 | −2.6 (−4.0 to −1.2) | 14.8 | −3.8 (−6.1 to −1.4) | −4.4 | 2.4 (0.8 to 4.0) | .002 (.01) | −8.9 | 3.6 (1.1 to 6.1) | .004 (.01) |
| Fair | 13.6 | −0.8 (−1.3 to −0.3) | 25.0 | −0.3 (−2.3 to 1.6) | 31.1 | 0.2 (−2.8 to 3.2) | −11.3 | −0.5 (−2.6 to 1.7) | .69 (.78) | −17.5 | −1.0 (−4.1 to 2.2) | .57 (.65) |
| Good or better | 80.7 | 0.9 (0.2 to 1.7) | 64.7 | 2.8 (0.3 to 5.2) | 53.9 | 3.1 (−0.6 to 6.8) | 15.9 | −1.8 (−4.5 to 0.9) | .20 (.38) | 26.8 | −2.1 (−6.1 to 1.8) | .30 (.40) |
| Mortality rate, per 100 000e | 1261.1 | −11.3 (−43.7 to 21.1) | 1902.6 | −7.0 (−61.8 to 47.9) | 1032.4 | −9.3 (−61.9 to 43.4) | −641.5 | −4.3 (−77.2 to 68.5) | .95 (.95) | 228.7 | −2.0 (−72.6 to 68.5) | .97 (.97) |
Columns present the expected mean at age 65 years, the age eligibility threshold for Medicare, which is based on the local linear association between age and the outcome. The expected means contain the counterfactual outcome at age 65 years in the absence of the treatment (ie, the expected outcome at age 65 years without Medicare).
Adjusted discontinuity estimates are in percentage points.
Column presents the expected disparity at age 65 years, the age eligibility threshold for Medicare, which is based on the local linear association between age and the outcomes for non-White and White populations. The expected disparity subtracts the expected mean for non-White populations from the expected mean for White populations at age 65 years.
Benjamini-Hochberg–corrected P values are presented in parentheses.
Mortality data are from the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research system. All other data are from the Behavioral Risk Factor Surveillance System. Because these data are deidentified, they could not be linked.