Immigrants Have Lower Health Care Expenditures Than U.S.-Born Residents, Study Says

Main Category: Public Health
Article Date: 27 Jul 2005 - 0:00 PDT

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Health care expenditures for US immigrants are about 55% less than those of U.S.-born residents, according to a study published on Monday in the... American Journal of Public Health, the Dallas Morning News reports (Jacobson, Dallas Morning News, 7/26). For the study, researchers from Harvard Medical School analyzed data from 21,241 participants in the Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality in 1998 (Semuels, Pittsburgh Post-Gazette, 7/26). The study did not distinguish between documented and undocumented immigrants. The study found:

• Immigrants on average received about $1,139 in health care in 1998, compared with $2,546 for native-born residents;
  


• Although immigrants accounted for 10% of the U.S. population in 1998, they accounted for only 8% of U.S. health care costs (Connolly, Washington Post, 7/26);
  


• Immigrant health care expenditures totaled $39.5 billion in 1998, with about $25 billion reimbursed by private health insurers, $11.7 billion reimbursed by government programs and $2.8 billion paid out of pocket;
  


• Latino immigrants on average spent $962 on health care in 1998, compared with $1,870 for native-born Latino residents;
  


• Black immigrants on average spent $1,030 on health care in 1998, compared with $2,524 by native-born black residents;
  


• White immigrants on average spent $1,747 on health care in 1998, compared with $3,117 for native-born white residents;
  


• 24.6% of immigrants lacked health insurance in 1998, compared with 10% of native-born residents (Dorschner, Miami Herald, 7/26);
  


• Health expenditures for immigrant children in 1998 were about 74% less than those of native-born children (Castillo, Austin American-Statesman, 7/26);
  


• Immigrant children received 71% less care in physician offices and 72% fewer medicines that native-born children in 1998; and
  


• Emergency department expenditures for immigrant children were three times the expenditures of native-born children (Pittsburgh Post-Gazette, 7/26).
  

Researchers have "no reason to think that the expenditure for immigrant care has gone up in recent years as a percentage of higher costs," study co-author Olveen Carrasquillo said (Dallas Morning News, 7/26). According to Elena Rios, president of the National Hispanic Medical Association, immigrants often live in low-income areas and have less access to hospitals, clinics, physicians and pharmacies. She added that limited education among immigrants also serves as a barrier to health care (Washington Post, 7/26).

Reaction
Study co-author Steffie Woolhandler said, "It's a complete myth that immigrants are a disproportionate burden. The majority have health insurance, and, even when they have insurance, they use a whole lot less" (Miami Herald, 7/26). Lead study author Sarita Mohanty said, "These findings help refute the popular mythologies that immigrants are placing a disproportionate burden on the health care system" (Austin American-Statesman, 7/26). She added, "The truth is, immigrants get far less care than other Americans. Our data indicates that many immigrants are actually helping to subsidize care for the rest of us" (Dallas Morning News, 7/26). However, Steven Camarota -- research director at the Center for Immigration Studies, which supports limits on immigration -- said, "The fact that immigrants, when uninsured, might use 27% less medical care doesn't change the fact that they're 200% more likely to be uninsured in the first place" (Washington Post, 7/26).

An abstract of the study is available online.

Boston Initiative
Massachusetts General Hospital executives are expected to announce on Tuesday the creation of a center designed to address health care disparities among racial and ethnic minorities in Massachusetts, the Boston Globe reports. MGH and Partners HealthCare System are pledging $3 million over five years to establish the Disparities Solutions Center. With the funding, a team of health care specialists will study why disparities exist between racial and ethnic groups and work to address the gaps. In addition, the money will establish an institute to train medical professionals on the issue of health care inequity and to underwrite a fellowship program for doctors-in-training (Smith, Boston Globe, 7/26). MGH staff will work with hospitals doctors, insurers, community health center, schools and governments in Massachusetts and around the country on the program (Fargen, Boston Herald, 7/26). According to the Globe, the initiative is the most recent example of the "growing urgency" in Boston to address health care inequality, and it's announcement comes a month after Boston Mayor Thomas Menino launched his own $1 million initiative to improve the city's health care system, including efforts for hospitals to track racial and ethnic inequalities in treatment of patients and train physicians to be more culturally sensitive. MGH executives said after the initial five-year investment, they hope grants from foundations and contracts from other hospitals seeking help with disparities projects will sustain the project (Boston Globe, 7/26).

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