Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2013, Article ID 627412, 17 pages
Research Article

Marked Ethnic, Nativity, and Socioeconomic Disparities in Disability and Health Insurance among US Children and Adults: The 2008–2010 American Community Survey

1US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA
2US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, 5600 Fishers Lane, Room 6A-55, Rockville, MD 20857, USA

Received 30 April 2013; Accepted 4 September 2013

Academic Editor: Anna Karakatsani

Copyright © 2013 Gopal K. Singh and Sue C. Lin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We used the 2008–2010 American Community Survey Micro-data Sample ( = 9,093,077) to estimate disability and health insurance rates for children and adults in detailed racial/ethnic, immigrant, and socioeconomic groups in the USA. Prevalence and adjusted odds derived from logistic regression were used to examine social inequalities. Disability rates varied from 1.4% for Japanese children to 6.8% for Puerto Rican children. Prevalence of disability in adults ranged from 5.6% for Asian Indians to 22.0% among American Indians/Alaska Natives. More than 17% of Korean, Mexican, and American Indian children lacked health insurance, compared with 4.1% of Japanese and 5.9% of white children. Among adults, Mexicans (43.6%), Central/South Americans (41.4%), American Indians/Alaska Natives (32.7%), and Pakistanis (29.3%) had the highest health-uninsurance rates. Ethnic nativity disparities were considerable, with 58.3% of all Mexican immigrants and 34.0% of Mexican immigrants with disabilities being uninsured. Socioeconomic gradients were marked, with poor children and adults having 3–6 times higher odds of disability and uninsurance than their affluent counterparts. Socioeconomic differences accounted for 24.4% and 60.2% of racial/ethnic variations in child health insurance and disability and 75.1% and 89.7% of ethnic inequality in adult health insurance and disability, respectively. Health policy programs urgently need to tackle these profound social disparities in disability and healthcare access.