Zhun Cao, PhD¹, Margarita Alegria, PhD¹, Thomas McGuire, PhD², and David Takeuchi, PhD³. (1) Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon Street, 4th Floor, Somerville, MA 02143, 617-503-8476, zcao@charesearch.org, (2) Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899, (3) University of Washington, 4101 15th Ave NE, Seattle, WA 98105-6299

This paper studies the role of vulnerabilities in poor health insurance outcomes. Vulnerability is defined by minority status, immigrant status, limited language proficiency and poor health. Insurance outcomes are defined as private insurance, no insurance from any source, and the extent of private insurance if any. This paper intends to find whether reliance on public insurance or having no insurance of any form is more common among racial/ethnic minorities, recent immigrants, and those with limited language proficiency in English. Furthermore, we will check if those with serious health problems, including mental illness, are less likely to be covered by insurance plans. We adapt the methodology for defining and assessing the mechanisms of health care disparities proposed by the IOM (2002) to the problem of disparities and mechanisms in health insurance. Quantification of disparities according to vulnerabilities will be done with simple linear models with adjustment by age and gender. Using the National Latino and Asian American Study (NLAAS) data, we conduct empirical analysis based on a proposed distinction between “differences” and “disparities” in health insurance outcomes on the elements of vulnerability. Preliminary finding shows that all of the elements of vulnerability we identify appear to have a meaningful impact on insurance outcomes.

Learning Objectives:

• To understand how elements of vulnerability affect disparities in health insurance coverage.

Keywords: Mental Health, Minorities

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.