Nearly one-third of SCHIP population in Oregon is Hispanic
71% of Hispanic parents do not speak English at home 55% of Hispanic children do not speak English at home
Research questions:
Do Hispanic children differ from non-Hispanic children? Are these differences explained by acculturation (as measured by language)?
Telephone survey of parents of children enrolled in OHP’s SCHIP Oversampled parents of Hispanic children Conducted in both English and Spanish in 2002 Included both currently enrolled, and recently disenrolled, children
N= 1,206
Response rate=53%
Hispanic Spanishspeaking (%) Child’s age (in years) 0-5 6-12 13-18 * 32.0 54.0 14.0 Englishspeaking (%) * 29.0 54.4 16.6
Non-Hispanic (%)
19.1 48.4 32.5
Two parent family At least one-parent employed full-time Parent is high school graduate
Parent born outside US
78.1*,† 87.6* 22.3*,†
94.0*,†
55.3 82.6* 85.4
10.3
55.9 69.8 83.8
8.4
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic Spanishspeaking (%) General health status is excellent/ very good
Special health care needs (based on LWI screener)
Englishspeaking (%) 76.5
Non-Hispanic (%)
51.7*,†
74.1
12.0*,†
25.2
30.5
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic
Spanishspeaking Englishspeaking Non-Hispanic
% with usual source Location of usual source (% distribution):
Community health center
92.5†
*,†
98.3
94.9
48.9
16.1
15.0
Hospital clinic Doctor’s office or HMO
Emergency room Child sees a particular doctor at this place (%)
32.7 14.2
4.2 68.0*,†
20.3 63.3
0.4 88.4
13.6 69.7
1.6 84.7
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic Spanishspeaking 48.3* Englishspeaking 53.2
Routine exam/ check-up Primary care visit (including check-up) Inpatient stay
Emergency room visit
Non-Hispanic 57.7 77.7
4.7 26.6
66.0*
5.1 25.3
69.9
6.9 28.9
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic
Spanishspeaking Englishspeaking Non-Hispanic
Primary care visits Specialist care Dental care
Prescription medicines
0.6*,† 1.3 9.1*,†
0.6
3.9 0.0 21.9
0.4*
5.2 3.1 18.9
2.6
Mental health care
0.5*,†
2.7
2.7
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic Spanish- Englishspeaking speaking Non-Hispanic
Average rating of child’s health care (scale of 0-10) Parent very or somewhat satisfied with benefit package (%) Paid out-of-pocket for some of child’s health care costs (% yes) 8.4 8.6 8.1
90.7*,†
81.6
87.5
9.9*
13.3
18.9
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic Spanishspeaking (%) Previously enrolled in the Oregon Health Plan
Previously covered by private insurance
Englishspeaking (%) 81.1
66.4
Non-Hispanic (%)
83.3*
29.7*,†
76.2
66.7
Previously paid a premium for health insurance
30.2*,†
55.2
67.4
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Hispanic
Spanishspeaking (%) Parent Eligible for ESI All Those employed full-time Parent had ESI (of those eligible for ESI)
Child Eligible for ESI All Those employed full-time Child had ESI (of those eligible for ESI)
Englishspeaking (%) 27.5 31.0 51.1
Non-Hispanic (%)
23.4 23.6* 56.0
22.4 34.2 57.6
18.7 20.0
32.1*,†
19.7 22.4
12.3
18.1 27.4
17.2
*Statistically different from non-Hispanic children at <0.05 level. †Statistically different from English-speaking Hispanic children at <0.05 level.
Despite having poorer health status, Spanishspeaking Hispanic children in SCHIP use fewer services.
Differences in perceptions of need for care May be cultural differences in rating health status
Covering Spanish-speaking Hispanic children through policies that promote ESI may be challenging.
Lack of experience with private insurance Reliance on traditional safety net providers
Important to consider acculturation when analyzing the experience of Hispanic children.