Health Expenditure Dynamics and Years of U.S. Residence: Analyzing Spending Disparities among Latinos by Citizenship/Nativity Status

Authors

  • Arturo Vargas Bustamante,

    1. Department of Health Services, UCLA School of Public Health, 650 Charles E. Young Drive, South Room 31-299C, Box 951772, Los Angeles, CA 90095
    Search for more papers by this author
    • Address correspondence to Arturo Vargas Bustamante, Ph.D., M.A., M.P.P., Assistant Professor, Department of Health Services, UCLA School of Public Health, 650 Charles E. Young Drive, South Room 31-299C, Box 951772, Los Angeles, CA 90095; e-mail: avb@ucla.edu. Jie Chen, Ph.D., Assistant Professor, is with the Department of Political Science, Economics, and Philosophy, College of Staten Island/City University of New York, Staten Island, NY.

  • Jie Chen

    1. Department of Political Science, Economics, and Philosophy, College of Staten Island/City University of New York, Staten Island, NY
    Search for more papers by this author

Abstract

Objective. We investigate health expenditure disparities between Latinos and non-Latino whites by years of United States residence and citizenship/nativity status.

Data Sources. We link the Medical Expenditure Panel Survey and the National Health Interview Survey from 2000 to 2007. The sample consists of 31,514 Latinos and 76,021 white adults (18–64 years).

Study Design. The likelihood of any health spending, total health expenditure, and the out-of-pocket (OOP) share of health expenditure are our main dependent variables. We use two-part multivariate models to adjust for confounding factors. A stratified analysis by insurance status checks for the results' robustness. The decomposition technique is implemented to estimate the share of disparities that can be explained by observed and unobserved variables.

Principal Findings. Latinos are much less likely to have any health spending (68 percent), total health expenditure (57 percent), and more likely to pay OOP (6 percent) compared with the white population. Overall, disparities narrow or disappear for naturalized Latinos the longer they stay in the country. Among noncitizen Latinos, disparities remain constant or decline slightly, but they remain large over time.

Conclusions. Low-health spending by foreign-born Latinos contributes to health expenditure disparities between Latinos and whites. Our findings provide preliminary evidence on health-spending convergence over time between foreign-born Latinos and that of whites.

Ancillary