Latinos and Health Policy

by

Amy Cabrera Rasmussen

• LAST REVIEWED: 25 March 2020
• LAST MODIFIED: 25 March 2020
• DOI: 10.1093/obo/9780199913701-0144

Introduction

Latinos make up a large and growing segment of the US population, while also having lower rates of health insurance coverage than other racial and ethnic groups within the US context. The 2010 Patient Protection and Affordable Care Act and, in particular, the ACA’s Medicaid expansion significantly altered the policy terrain in practical and research terms. Estimates are that, as of 2017, as many as four million non-elderly Latinos gained insurance coverage who did not have it prior to the policy’s enactment. Yet Latinos remain least likely to be covered by private insurance, and many are ineligible for government health subsidies or programs due to their residence in states that did not participate in the expansion of Medicaid, as well as the status of a segment of this population that is undocumented. Such data also shows that Hispanic youth are more likely to lack coverage compared to their peers. Despite much discussion and debate about a Latino epidemiological paradox, there are also significant health inequities experienced among Latinos in regard to specific health issues, such as HIV diagnoses, being less likely to have a usual source of care, or living in a household that is food insecure. In addition, because the Latino population is heterogeneous in many ways, ranging from national origin, immigrant status, economics, educational attainment, and more, it is often difficult to speak in sweeping generalizations about Latinos’ views and experiences with health care and health policy. Race, ethnicity, and interlinked notions of deservingness figure prominently in contemporary debates about health reform measures. And Latinos, especially via the frequent conflation of Latinos with immigrants, have often taken center stage in these discussions among policymaking elites and the broader public alike. The intersections of these various factors mean that Latinos’ health and well-being are impacted significantly by health policy making: what happens in national health policy matters to the Latino community. Additionally, while Latinos live in every state in the nation, Latinos’ concentration in states such as California, Texas, New Mexico, New York, and Florida mean that state-level policy actions can also have a significant impact on coverage rates and outcomes. Health policy is also affected by Latinos: images and narratives of the Latino community, and especially its immigrant segments, can shape the broader health policy terrain. The materials in this bibliography tend toward the contemporary moment and recent publications; the reader will note that while a piece may be situated in one substantive category, many of the materials also have clear utility to several of the other substantive sections. I would like to acknowledge the substantial contributions to the project of Noelle A. Chin for her work assisting me in gathering the relevant research literature.

Foundational and Contextual Materials

The sources below provide some foundational information to inform the examination of Latinos and health policy. The websites of the US Census Bureau (2018) and US Department of Health and Human Services provide overviews of health insurance coverage data and relevant federal health policy concerning race, ethnicity, and health, including a trove of documents and plans related to reducing health disparities and the results of a significant national study of Latinos and health (2013, 2018). Velasco-Mondragon, et al. 2016 provides a thorough review of the relevant research literature. The World Health Organization website and the documents it contains help to situate domestic data and initiatives within a larger regional and global context and supply some useful contextual frameworks that have gained support within international governmental and nongovernmental bodies.

• National Heart, Lung, and Blood Institute. Hispanic Community Health Study/Study of Latinos: Data Book: A Report to the Communities. Washington, DC: US Department of Health and Human Services, 2013.

  Funded by the National Institutes of Health, this is the largest health study of Latinos, conducted in two phases between 2006–2013 and from 2013–2019. The study engages a range of health issues of concern to the Latino community and includes survey questionnaires as well as physical examinations of participants. Findings can be used to inform health policy initiatives at all levels of government. See also the main study website.

• US Census Bureau. Health Insurance Coverage in the United States: 2017—Current Population Reports. Washington, DC: US Census Bureau, September 2018.

  Updated annually, this report from the Census Bureau provides data on health insurance coverage in the United States; includes information specific to Latinos/Hispanics as well as comparative information for other racial and ethnic groups, in addition to data based on other key characteristics beyond race and ethnicity such as age and income.

• US Department of Health and Human Services, Office of Minority Health.

  This federal government office’s website contains a wide array of data, reports, and policy initiatives related to minority health in the United States. Documents of particular interest include a profile of Hispanic/Latino health, the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and the National Partnership for Action to End Health Disparities, which includes the National Stakeholder Strategy for Achieving Health Equity, and more.

• Velasco-Mondragon, Eduardo, Angela Jimenez, Anna Palladino-Davis, Dawn Davis, and Jose Escamilla-Cejudo. “Hispanic Health in the USA: A Scoping Review of the Literature.” Public Health Reviews 37.1 (2016): 31.

  DOI: 10.1186/s40985-016-0043-2

  This piece is a thorough collection and analysis of the research and related literature that seeks to identify the “priority issues, needs, and services germane to the health of Hispanics in the USA.” It focuses on social determinants of health, health inequalities, and risk factors. The piece also provides recommendations for both future research and policy interventions, including a discussion of access to care and a health-integrated policy approach.

• World Health Organization.

  Contains information and statistics, conceptual materials, and policy documents that help to put Latino-focused health policy and US health policy in perspective, both within the Americas and globally. Useful reports and publications include, for example, the Health in All Policies framework, Closing the Gap: Policy into Practice on Social Determinants of Health, Mental Health without Borders, and more. Follow the links by health topic or country.