Table 3. Relative Racial and Ethnic Differences in the Adjusted Prevalence of Health Status and Health Care Access, Utilization, and Affordability Measures in 1999 and 2018a.
| Difference between Asian and White individuals | Difference between Black and White individuals | Difference between Latino/Hispanic and White individuals | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Percentage points (95% CI) | Difference in difference | Percentage points (95% CI) | Difference in difference | Percentage points (95% CI) | Difference in difference | |||||||
| 1999 | 2018 | Percentage points (95% CI) | P value | 1999 | 2018 | Percentage points (95% CI) | P value | 1999 | 2018 | Percentage points (95% CI) | P value | |
| Poor or fair health status | ||||||||||||
| Overall | +0.61 (−1.74 to +2.96) | −1.54 (−3.27 to +0.20) | −2.14 (−5.07 to +0.78) | .15 | +8.29 (+6.57 to +10.02) | +6.03 (+4.23 to +7.83) | −2.26 (−4.75 to +0.23) | .08 | +4.95 (+3.46 to +6.45) | +5.13 (+3.48 to +6.79) | +0.18 (−2.05 to +2.41) | .88 |
| Low income | −0.47 (−8.39 to +7.46) | −8.04 (−12.64 to −3.45) | −7.57 (−16.74 to +1.59) | .11 | +9.48 (+6.56 to +12.41) | +2.82 (−0.81 to +6.45) | −6.67 (−11.33 to −2.01) | .005 | −0.24 (−2.75 to +2.27) | −1.71 (−4.98 to +1.56) | −1.47 (−5.59 to +2.66) | .49 |
| Middle and high income | +0.06 (−3.26 to +3.38) | −0.29 (−2.04 to +1.47) | −0.35 (−4.11 to +3.41) | .86 | +2.14 (+0.22 to +4.06) | +2.70 (+1.06 to +4.34) | +0.56 (−1.97 to +3.09) | .67 | +3.24 (+1.54 to +4.95) | +3.59 (+1.84 to +5.34) | +0.34 (−2.09 to +2.78) | .78 |
| Functional limitation | ||||||||||||
| Overall | −10.66 (−13.90 to −7.42) | −14.50 (−17.71 to −11.28) | −3.84 (−8.40 to +0.73) | .10 | −0.26 (−2.49 to +1.97) | +0.35 (−2.57 to +3.28) | +0.61 (−3.07 to +4.29) | .74 | −7.17 (−9.08 to −5.26) | −5.53 (−8.28 to −2.77) | +1.64 (−1.71 to +5.00) | .34 |
| Low income | −17.65 (−24.84 to −10.46) | −21.96 (−29.34 to −14.59) | −4.31 (−14.62 to +5.99) | .41 | −1.55 (−5.14 to +2.05) | −8.11 (−12.96 to −3.26) | −6.56 (−12.60 to −0.52) | .03 | −16.94 (−20.28 to −13.59) | −19.71 (−23.80 to −15.62) | −2.77 (−8.06 to +2.51) | .30 |
| Middle and high income | −9.30 (−13.24 to −5.35) | −13.18 (−16.61 to −9.75) | −3.89 (−9.11 to +1.34) | .15 | −5.05 (−7.64 to −2.46) | −1.81 (−5.37 to +1.75) | +3.24 (−1.16 to +7.64) | .15 | −5.88 (−8.40 to −3.37) | −4.50 (−8.04 to −0.95) | +1.38 (−2.96 to +5.73) | .53 |
| Severe psychological distress | ||||||||||||
| Overall | −1.44 (−2.05 to −0.83) | −1.81 (−2.89 to −0.72) | −0.36 (−1.61 to +0.88) | .57 | +0.77 (+0.15 to +1.39) | +0.55 (−0.63 to +1.72) | −0.22 (−1.55 to +1.11) | .75 | +0.91 (+0.25 to +1.57) | +0.94 (−0.07 to +1.95) | +0.03 (−1.17 to +1.23) | .96 |
| Low income | −3.27 (−5.19 to −1.35) | −5.42 (−7.79 to −3.04) | −2.15 (−5.20 to +0.91) | .17 | +0.11 (−1.15 to +1.38) | −1.46 (−3.80 to +0.88) | −1.58 (−4.24 to +1.08) | .25 | −0.65 (−1.75 to +0.45) | −2.20 (−4.00 to −0.40) | −1.55 (−3.66 to +0.56) | .15 |
| Middle and high income | −1.02 (−1.81 to −0.24) | −0.95 (−2.22 to +0.31) | +0.07 (−1.42 to +1.56) | .93 | −0.07 (−0.82 to +0.68) | −0.28 (−1.35 to +0.80) | −0.21 (−1.52 to +1.10) | .75 | +0.56 (−0.30 to +1.41) | +0.68 (−0.60 to +1.96) | +0.12 (−1.41 to +1.66) | .87 |
| Lack of health insurance at the time of interview | ||||||||||||
| Overall | +5.75 (+2.62 to +8.87) | +0.06 (−1.50 to +1.62) | −5.68 (−9.18 to −2.19) | .001 | +5.21 (+3.75 to +6.67) | +3.03 (+1.73 to +4.33) | −2.18 (−4.13 to −0.23) | .03 | +17.52 (+15.68 to +19.36) | +12.19 (+10.08 to +14.29) | −5.33 (−8.13 to −2.54) | <.001 |
| Low income | +11.93 (+4.38 to +19.48) | −1.93 (−5.83 to +1.97) | −13.86 (−22.36 to −5.36) | .001 | +1.53 (−1.21 to +4.27) | +0.67 (−1.78 to +3.12) | −0.86 (−4.54 to +2.82) | .65 | +19.41 (+16.30 to +22.52) | +15.37 (+11.62 to +19.12) | −4.04 (−8.91 to +0.83) | .10 |
| Middle and high income | +2.52 (−0.38 to +5.42) | +0.22 (−1.41 to +1.86) | −2.30 (−5.63 to +1.03) | .18 | +1.93 (+0.43 to +3.44) | +1.78 (+0.35 to +3.20) | −0.16 (−2.23 to +1.92) | .88 | +8.41 (+6.66 to +10.16) | +6.28 (+4.45 to +8.11) | −2.13 (−4.66 to +0.40) | .10 |
| No usual source of care at the time of interview | ||||||||||||
| Overall | +6.42 (+3.36 to +9.48) | +1.08 (−0.87 to +3.03) | −5.34 (−8.97 to −1.71) | .004 | +2.47 (+0.96 to +3.98) | +3.10 (+1.28 to +4.93) | +0.63 (−1.74 to +3.00) | .60 | +9.76 (+8.13 to +11.40) | +6.58 (+4.75 to +8.41) | −3.18 (−5.63 to −0.73) | .01 |
| Low income | +15.28 (+7.55 to +23.00) | −0.47 (−5.18 to +4.24) | −15.75 (−24.80 to −6.70) | <.001 | −0.06 (−2.49 to +2.38) | +1.28 (−1.82 to +4.37) | +1.34 (−2.60 to +5.28) | .51 | +10.74 (+8.01 to +13.48) | +5.08 (+1.93 to +8.22) | −5.67 (−9.83 to −1.50) | .008 |
| Middle and high income | +3.20 (+0.31 to +6.09) | +1.26 (−0.92 to +3.44) | −1.94 (−5.56 to +1.67) | .29 | +1.25 (−0.53 to +3.03) | +1.20 (−0.92 to +3.32) | −0.05 (−2.82 to +2.72) | .97 | +5.06 (+3.31 to +6.82) | +4.17 (+2.21 to +6.13) | −0.89 (−3.52 to +1.73) | .51 |
| Not seen or talked to a health professional in the past 12 mo | ||||||||||||
| Overall | +7.35 (+4.35 to +10.35) | +7.44 (+4.65 to +10.24) | +0.09 (−4.01 to +4.20) | .97 | +0.80 (−0.67 to +2.27) | +1.26 (−0.37 to +2.89) | +0.46 (−1.74 to +2.65) | .68 | +8.68 (+7.11 to +10.26) | +8.18 (+6.27 to +10.09) | −0.51 (−2.98 to +1.97) | .69 |
| Low income | +11.94 (+3.92 to +19.95) | +5.82 (+0.12 to +11.52) | −6.12 (−15.95 to +3.72) | .22 | −1.11 (−3.67 to +1.46) | −0.17 (−3.02 to +2.67) | +0.93 (−2.89 to +4.76) | .63 | +10.22 (+7.54 to +12.90) | +7.54 (+4.45 to +10.64) | −2.68 (−6.77 to +1.41) | .20 |
| Middle and high income | +5.53 (+2.20 to +8.86) | +7.83 (+4.55 to +11.11) | +2.30 (−2.38 to +6.98) | .34 | +0.67 (−1.17 to +2.52) | +0.36 (−1.70 to +2.42) | −0.31 (−3.08 to +2.45) | .82 | +5.30 (+3.37 to +7.23) | +6.52 (+4.24 to +8.80) | +1.22 (−1.77 to +4.21) | .43 |
| Foregone or delayed medical care due to cost in the past 12 mo | ||||||||||||
| Overall | −3.97 (−6.06 to −1.88) | −6.58 (−8.18 to −4.97) | −2.61 (−5.24 to +0.03) | .05 | +2.94 (+1.48 to +4.41) | +3.10 (+1.28 to +4.93) | +0.16 (−2.18 to +2.50) | .89 | +1.39 (+0.16 to +2.63) | +0.62 (−0.91 to +2.15) | −0.77 (−2.73 to +1.20) | .44 |
| Low income | −8.87 (−13.94 to −3.80) | −14.45 (−18.32 to −10.58) | −5.58 (−11.96 to +0.80) | .09 | −0.19 (−2.91 to +2.54) | −3.01 (−6.10 to +0.07) | −2.83 (−6.94 to +1.29) | .18 | −5.28 (−7.52 to −3.05) | −5.97 (−8.79 to −3.15) | −0.68 (−4.28 to +2.92) | .71 |
| Middle and high income | −3.20 (−5.02 to −1.37) | −4.87 (−6.62 to −3.12) | −1.68 (−4.21 to +0.85) | .19 | −0.09 (−1.63 to +1.45) | +2.63 (+0.22 to +5.04) | +2.72 (−0.14 to +5.58) | .06 | +0.72 (−0.77 to +2.21) | −0.19 (−2.12 to +1.73) | −0.91 (−3.34 to +1.52) | .46 |
a
Data source is the National Health Interview Survey from years 1999 to 2018. Definitions of each outcome are shown in Study Outcomes in the Methods section. For all measures, a negative sign in any 1 year indicates a more socially positive result in comparison with the White population (ie, increased percentage of people with insurance coverage, increased percentage of people with a usual source of care, increased percentage of people with recent health care utilization, reduced percentage of people with unmet medical needs due to cost, reduced percentage of people with poor or fair health status, reduced percentage of people with severe psychological distress, and reduced percentage of people with functional limitations). Likewise, a difference-in-difference result that is negative indicates a socially positive change in comparison with the White population over the same timeframe. Of note, the Affordable Care Act was enacted in March 2010. Rates of each measure were adjusted for age, sex, and US region.