Key Facts on Health and Health Care by Race and Ethnicity
Coverage, Access to, and Use of Care
All racial and ethnic groups experienced improvements in coverage, access to care, and use of care compared to prior to the ACA (Figure 12), and some disparities between groups of color and Whites narrowed. Hispanics and Blacks experienced improvements in the largest number of the examined measures related to coverage, access, and use. Despite these improvements, nonelderly Blacks and Hispanics continued to fare worse than Whites across most examined indicators of coverage, access, and use (Figure 13). Nonelderly Asians generally fared similar to Whites across measures. However, the data may mask underlying differences and disparities among subgroups of Asians. Gaps in the data limit the ability to assess access and utilization of care for NHOPIs.
All groups experienced large decreases in their uninsured rate since implementation of the ACA, but disparities in coverage persisted as of 2017 (Figure 14). All groups of color had larger percentage-point decreases in their uninsured rate compared to Whites, which narrowed coverage disparities. Hispanics experienced the largest absolute decrease, with their uninsured rate falling from 30% to 19%. Despite these larger gains in coverage, most groups of color remained more likely to be uninsured relative to Whites as of 2017. In particular, nonelderly Hispanics were nearly three times as likely as Whites to lack coverage (19% vs. 7%) and nonelderly AIANs were over three times as likely as Whites to be uninsured (22% vs. 7%) as of 2017.
Access to Care
Nearly all groups had decreases in the share of nonelderly adults reporting going without seeing a doctor due to cost between 2013 and 2018 (Figure 15). Relatively larger decreases for Blacks, Hispanics, and AIANs narrowed their disparity compared to Whites over this period. However, as of 2018, Blacks, Hispanics, AIANs, and NHOPIs were more likely than Whites to report going without needed care due to cost.
There were also decreases in the share of nonelderly adult Blacks and Hispanics who reported delaying care for reasons other than cost between 2013 and 2018 (Figure 16). Despite the decrease, as of 2018, Blacks and Hispanics were more likely to report delaying care for reasons other than cost compared to Whites. In addition, AIANs were nearly twice more likely than Whites to delay care due to other reasons than cost in 2018 (36% vs. 19%).
Between 2013 and 2018, the share of nonelderly adults with no usual source of care when sick decreased among Hispanics (Figure 17). However, Blacks and Hispanics were more likely than Whites to lack a usual source of care as of 2018. Across groups, small shares of children lacked a usual source of care, but the share of Black children with no usual source of care increased from 4% to 8% between 2013 and 2018. As of 2018, Black and Hispanic children were more likely than White children to not have a usual source of care. Data gaps limit the ability to measure the likelihood of having a usual source of care among NHOPIs and AIAN children.
Use of Care
The share of nonelderly adults going without health and dental care in the last year decreased for White, Black, and Hispanic nonelderly adults between 2013 and 2018 (Figure 18). There were no changes in the share of nonelderly adult Asians or AIANs using health or dental care between 2013 and 2018, and data are insufficient to assess use for NHOPIs. The increases in use of health and dental care narrowed disparities between groups of color and Whites. However, as of 2018, most groups of color were more likely to go without a health care or dental visit compared to Whites.
Across groups, a small share of children reported going without a health care visit in the past year, and there were no changes in health care use among children between 2013 and 2018. As of 2018, Hispanic and Asian children were more likely than White children to go without a health care visit in the past year (Figure 19). The share of Black, Hispanic, and Asian children going without dental care decreased over the period. Data gaps limited assessment of use of care for AIAN and NHOPI children.
There were no changes in rates of young children who did not receive all recommended immunizations across groups between 2013 and 2017 (Figure 20). As of 2017, Black children were more likely than White children to not have received all recommended immunizations (33% vs. 28%). Data were not available for NHOPI children.
In both 2012 and 2018, a smaller share of Black women did not receive a mammogram in the past two years compared to White women (Figure 21). Changes in the share of women receiving a Pap smear were mixed. From 2012 to 2018, the share who did not receive a Pap smear increased among White, Black, Hispanic, and Asian women. As of 2018, Asian women were more likely than White women to go without a Pap smear, while Black and Hispanic women were less likely to go without a Pap smear compared to Whites.