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Hispanic Health and Health Care Issues in Texas and the United States. Karl Eschbach, Ph.D. University of Texas Medical Branch. Purpose. To give a context for understanding health care accessibility issues for Hispanics in Texas and the United States. Topics of remarks.

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Hispanic health and health care issues in texas and the united states l.jpg

Hispanic Health and Health Care Issues in Texas and the United States

Karl Eschbach, Ph.D.

University of Texas Medical Branch


Purpose l.jpg
Purpose United States

  • To give a context for understanding health care accessibility issues for Hispanics in Texas and the United States


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Topics of remarks United States

1) Population growth

2) Composition of the Hispanic population

3) Health status of Hispanics

4) Health care access

5) Regional burden in Texas

6) The undocumented population



Hispanics in texas and united states l.jpg
Hispanics in Texas and United States United States

  • United States, 2004:

    • 41.3 million;

    • 14.1 %

  • Texas, 2003:

    • 7.6 million

    • 34.2 %

Source: U.S. Census Estimates Program


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Projected Hispanic Growth to 2040, U.S. & Texas United States

Sources: U.S. Census Bureau; Texas State Data Center


Composition l.jpg
Composition United States

  • 86%+ of Texas Hispanics are Mexican origin (U.S.=60%)

  • 31% of Texas Hispanics are immigrants (U.S.=40%)

  • Hispanics have lower average education

  • Concentration in service work, precision production, craft, repair, construction and transportation


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Health status: United Statesthe Hispanic Paradox

  • Low age-specific mortality rates for the Hispanic population of the United States compared to the non-Hispanic White population despite socio-economic disadvantage.


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Mortality by Hispanic Status United States(Sorlie et al JAMA 1993)

  • Standarized mortality rate ratio for

    Hispanics vs. Non-Hispanic Whites:

    .74 men .82 women

  • Lower heart disease and cancer mortality

  • Birth outcomes are similar to non-Hispanic Whites

  • Hispanic advantage is larger for immigrants


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Cause of the mortality advantage United States

  • Better health behaviors

  • Health selective migration


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Implications United States

  • Hispanics do not impose an excessive health care burden because of poor health habits, extra burden of illness, higher use of medical care


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Limited access to health insurance coverage United States

  • Concentration in industries and occupations with limited insurance coverage.

  • Unauthorized migration status limits access to public programs.


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Health Insurance, U.S. Hispanics, 2003 United States

Source: National Health Interview Survey, 2003


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No health insurance, 2003, National data United States

Source: National Health Interview Survey, 2003


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Implications of lower insurance coverage United States

  • Lower rates of health care utilization

  • Lower screening and immunization rates

  • Less likely to have a regular provider of care

  • Shorter survival after diagnosis

  • Informal cross-border health care utilization


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Unauthorized immigrant populations United States

  • 80%+ of recent Mexican immigrants are unauthorized

  • 1.4 million in Texas, 10 million in U.S.

  • 31 % of undocumented households include citizen children

Source: Jeffrey Passel, Pew Hispanic Center


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Implications United States

  • Texas and the United States depend on immigrant labor

  • Neither employers or federal/state government take responsibility for paying for medical care

  • Burden falls on the local hospital districts and other providers and on the immigrants


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County of residence of Texas Hispanics United States

Blue=U.S. Born

Red=Immigrants


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Implications of regional concentration United States

  • Local concentrations of un-insured immigrant populations in major metropolitan centers burdens local hospital districts.

  • South Texas border communities have low coverage rates despite more native presence.


Conclusions l.jpg
Conclusions United States

  • Hispanics are a rapidly growing population

  • Hispanics are a relatively healthy population

  • Health insurance rates are far lower

  • Health care access is impaired

  • Burden on local health care providers

  • Trends will magnify these problems if they are not addressed