Paul Ricci, MS MA PhD(c)HealthCare for All Pennsylvania, University of Pittsburgh
Congressman Joseph Wilson R-SC exclaimed “you lie” when PresidentObama stated that the law would not cover illegal immigrants.
In 2006, Hazleton, PA (pop. 25,340) passed an ordinance which fined and denied permits to businesses and landlords who hired and/or rented out to illegal immigrants and made English the official language of the town. ◦ Law was declared unconstitutional but it inspired similar measures in states such as Arizona. ◦ According to the Census, the city was 4.9% Latino in 2000 and 37.3% in 2010 (661% increase). The city total pop. increased 8.6% from 2000-2010. ◦ Reasons cited for this, with little evidence given, was that immigrants drain the healthcare and other resources of the town.
◦ Luzerne County, where Hazelton, PA is located, had an uninsured rate of 8.2% (Margin of Error (MOE) +/- 1.9%) in 2000 and 9.9% (MOE +/-1.6%) in 2007. The change is within the margin of errors for both years so no conclusions can be drawn.◦ According to the Census, the county had a population of 320,918 in 2010, a 0.5% change from 2000. The Latino population increased 440% over the same period.
The Census Bureau provides county and state level for the uninsured in the annual Small Area Health Insurance Estimates or SAHIE At the state level the numbers are broken down by ethnicity and gender but only by gender at the county level for 2008 and 2009. These data were correlated with other county level data such as Latino population to provide an indication of county level patterns for PA’s 67 counties.
Year % State % White % African % Latino American2008 10.6 9.10 15.10 21.502009 11.7 10.10 16.20 22.60 Political pundits often blame minorities for draining government services however according to the Kaiser Foundation in Pennsylvania 63% of Medicaid recipients were white while 19% were black and 14% were Hispanic in 2010. Nationally 43% are white, 21% are black, and 28% are Hispanic. 5.7% of PA residents are Latino while they are 16.3% of the nations population. In 2002, 2% of all PA Medicaid recipients were immigrants of any nationality.
Other County level health and demographic variables were collected from sources such as websites like County Health Rankings. They were correlated with the % uninsured and % Latino populations. They were also studied together in an exploratory factor analysis to identify latent variables among the counties and to see where the percents Latino and uninsured would load.
35 county level variables were entered into the model. Four factors were extracted accounting for a total of 71% of the variability in the county data. The top loadings for each factor are presented in the table on the next slide.
Factor 1 – Factor 2 – Factor 3 – Factor 4 – Mortality Uninsured Ethnic Clustering Infrastructure 35.9% of Variance 19.7% of Variance 9.6% of Variance 5.7% of Variance Variable Loading Variable Loading Variable Loading Variable Loading1 Male Life Expectancy -0.916 % Unins 2009 0.900 % No English 0.920 Physical 0.912 Environ.2 Years Behind Male 0.897 % Unins 2008 0.876 % African- 0.806 Built 0.591 American Environ.3 Female Life Expectancy -0.876 % Illiterate 0.789 % Asian 0.7574 0.873 Education 0.758 % Latino 0.726 Years Behind Female5 Years Poten. Life Lost 0.861 % in 200% of 0.625 Community 0.722 Poverty Safety
The county level correlation was compared to that of Texas because ◦ Texas has the highest overall uninsured rate in the US at 26.3% (Margin of Error +/- 0.2%). ◦ As a border state it has a large Latino population. 39.3% of Texas Latino population is uninsured. ◦ According to the Kaiser Foundation, 62% of it’s Medicaid recipients are Hispanic/Latino. ◦ It has 254 counties which is a good sample size.
Texas PennsylvaniaA fairly strong association was found for Texas accounting for23.4% of the variance (p<0.001). For Pennsylvania it wasweak accounting for almost 0.006%.
First Factor (26.2% of variability) Mortality variables loaded. Second Factor (22.5% of Var) % Latino loaded strongly but % Uninsured weakly. Third Factor (11% of Var) % Uninsured loaded more strongly with income.
Although there is a large percentage of the Latino population without health insurance in Pennsylvania there does not appear to be an association at the county level between uninsured rates and county Latino population. The real issue is a lack of a national health insurance program. ◦ The Affordable Care Act (ACA) does not guarantee universal coverage and excludes illegal immigrants.