NCHS Data Brief ■ No. 55 ■ January 2011

u.s. department of health and human services

Centers for Disease Control and Prevention

National Center for Health Statistics

Young Adults Seeking Medical Care: Do Race and Ethnicity 

Matter?

Barbara Bloom, M.P.A. and Robin A. Cohen, Ph.D.

Key findings

Data from the National 

Health Interview Survey: 

2008–2009

•	 More than one-half of 

Hispanic young adults aged 

20–29 years were uninsured 

in 2008–2009 compared with 

one-third of non-Hispanic 

black young adults and almost 

one-quarter of non-Hispanic 

white young adults.

•	 Among young adults aged 

20–29 years, non-Hispanic 

white (66%) young adults 

were twice as likely as 

Hispanic (33%) young 

adults to have private health 

insurance coverage.

•	 Approximately equal 

percentages of Hispanic, 

non-Hispanic white, and nonHispanic black young adults 

with private health insurance 

or Medicaid had a usual 

source of medical care.

•	 Uninsured non-Hispanic 

white (37%) and non-Hispanic 

black (33%) young adults 

were more likely to have 

unmet medical need than 

uninsured Hispanic (21%) 

young adults.

Health care disparities among different racial and ethnic subgroups in the 

United States are of national concern. Health insurance is a key factor in the 

access to medical care services, and young adults in the United States aged 

20–29 years are more likely than adults aged 30 years and over to lack health 

insurance coverage (1–4). A previous report has examined the differences 

in health insurance and access to health care by gender among young adults 

aged 20–29 years (5). This report focuses on the differences in health 

insurance and access to health care among Hispanic, non-Hispanic white, and 

non-Hispanic black young adults aged 20–29 years.

Keywords: health insurance • access to medical care • National Health 

Interview Survey

Does health insurance coverage differ by race and ethnicity 

for young adults?

•	 More than one-half of Hispanic young adults aged 20–29 years were 

uninsured in 2008–2009 compared with one-third of non-Hispanic 

black young adults and almost one-quarter of non-Hispanic white young 

adults (Figure 1).

0

20

40

60

80

100

Uninsured

Other

Medicaid

Private

Non-Hispanic

black

Non-Hispanic

white

All races and Hispanic

ethnicities

Percent

31.3

56.2

10.2

53.6

32.5

12.3

24.3

65.7

7.7

34.0

43.4

20.4

Figure 1. Distribution of insurance coverage status for adults aged 20–29 years, by race and 

ethnicity: United States, 2008–2009

NOTE: The category “All races and ethnicities” includes races and ethnicities not shown separately. 

SOURCE: CDC/NCHS, National Health Interview Survey, all adults aged 20–29 years from the Family Core Component.
NCHS Data Brief ■ No. 55 ■ January 2011

■  2  ■

•	 Non-Hispanic white (66%) young adults were twice as likely as Hispanic (33%) young 

adults and one and one-half times as likely as non-Hispanic black (43%) young adults to 

have private health insurance coverage.

•	 Non-Hispanic black (20%) young adults were more likely to have Medicaid coverage than 

Hispanic (12%) young adults or non-Hispanic white (8%) young adults.

Does access to medical care differ by race and ethnicity for young adults?

•	 Hispanic (55%) young adults aged 20–29 years were less likely to have had a usual source 

of medical care than non-Hispanic black (68%) or non-Hispanic white (72%) young adults 

(Figure 2).

•	 Approximately equal percentages of Hispanic, non-Hispanic white, and non-Hispanic black 

young adults had a usual source of medical care, for those with private health insurance 

(79%–81%) or Medicaid (82%–85%).

•	 Among uninsured young adults, non-Hispanic white (47%) and non-Hispanic black (40%) 

young adults were more likely to have had a usual source of medical care than Hispanic 

(33%) young adults.

Figure 2. Percentage of adults aged 20–29 years who had a usual source of medical care, by insurance coverage status 

and race and ethnicity: United States, 2008–2009

NOTE: The category “All races and ethnicities” includes races and ethnicities not shown separately. 

SOURCE: CDC/NCHS, National Health Interview Survey, all adults aged 20–29 years from the Sample Adult Component. Percent

0

20

40

60

80

100

All races and ethnicities Hispanic Non-Hispanic white Non-Hispanic black

Total Private Medicaid Uninsured

68.2

72.1

68.3

79.4 79.6 79.4 80.8 82.7 82.1 81.8 84.5

41.3

32.9

47.1

40.2

55.4

Does having a doctor visit in the past year differ by race and ethnicity for 

young adults?

•	 Overall, non-Hispanic white (76%) and non-Hispanic black (76%) young adults aged 20–29 

years were more likely to have had a doctor visit in the past year than Hispanic (61%) young 

adults (Figure 3).
NCHS Data Brief ■ No. 55 ■ January 2011

■  3  ■

•	 Non-Hispanic white (80%) and non-Hispanic black (81%) young adults with private 

insurance were more likely to have had a doctor visit in the past year than Hispanic (74%) 

young adults with the same coverage.

•	 Non-Hispanic white young adults with Medicaid (88%) were more likely to have had a 

doctor visit in the past year than Hispanic young adults with the same coverage (80%).

•	 Uninsured non-Hispanic white (60%) and non-Hispanic black (60%) young adults were 

more likely to have had a doctor visit in the past year than uninsured Hispanic (47%) young 

adults.

Figure 3. Percentage of adults aged 20–29 years who had a doctor visit in the past year, by insurance coverage status and 

race and ethnicity: United States, 2008–2009

NOTE: The category “All races and ethnicities” includes races and ethnicities not shown separately. 

SOURCE: CDC/NCHS, National Health Interview Survey, all adults aged 20–29 years from the Sample Adult Component. Percent

0

20

40

60

80

100

All races and ethnicities Hispanic Non-Hispanic white Non-Hispanic black

Total Private Medicaid Uninsured

72.8 76.2 75.7

79.4

74.4

80.2 81.4

85.3

79.6

88.3 86.2

55.3

46.5

60.6 59.9 60.0

Does emergency room use differ by race and ethnicity for young adults?

•	 Overall, non-Hispanic black (14%) young adults aged 20–29 years were more likely 

than non-Hispanic white (9%) or Hispanic (8%) young adults to have had two or more 

emergency room visits in the past year (Figure 4).

•	 Among young adults with private health insurance, approximately equal percentages of 

Hispanic (6%), non-Hispanic white (7%), and non-Hispanic black (8%) young adults had 

two or more emergency room visits in the past year.

•	 Non-Hispanic black young adults with Medicaid (27%) were more likely to have had two 

or more emergency room visits in the past year than Hispanic young adults with the same 

coverage (18%).

•	 Uninsured non-Hispanic white (11%) and non-Hispanic black (12%) young adults were 

about twice as likely to have had two or more emergency room visits in the past year as 

uninsured Hispanic (6%) young adults.
NCHS Data Brief ■ No. 55 ■ January 2011

■  4  ■

Figure 4. Percentage of adults aged 20–29 years who had two or more visits to the emergency room in the past year, by 

insurance coverage status and race and ethnicity: United States, 2008–2009

NOTE: The category “All races and ethnicities” includes races and ethnicities not shown separately. 

SOURCE: CDC/NCHS, National Health Interview Survey, all adults aged 20–29 years from the Sample Adult Component. Percent

0

5

10

15

20

25

30

All races and ethnicities Hispanic Non-Hispanic white Non-Hispanic black

Total Private Medicaid Uninsured

9.3 9.3

13.8

6.5 6.3 6.8

8.4

22.9

17.5

24.4

26.7

9.5

6.4

11.2 11.5

8.0

Does unmet medical need differ by race and ethnicity for young adults?

•	 Overall, non-Hispanic white (17%) or non-Hispanic black (18%) young adults aged 20–29 

years were more likely to have had unmet medical need due to cost in the past year than 

Hispanic (15%) young adults (Figure 5).

•	 Among young adults with private insurance, non-Hispanic white (10%) young adults were 

more likely than Hispanic (8%) young adults to have had unmet medical need due to cost.

Figure 5. Percentage of adults aged 20–29 years who did not get or delayed medical care in the past year due to cost, by 

insurance coverage status and race and ethnicity: United States, 2008–2009

NOTE: The category “All races and ethnicities” includes races and ethnicities not shown separately. 

SOURCE: CDC/NCHS, National Health Interview Survey, all adults aged 20–29 years from the Family Core Component. Percent

0

10

20

30

40

All races and ethnicities Hispanic Non-Hispanic white Non-Hispanic black

Total Private Medicaid Uninsured

16.1 16.5 17.6

9.1 7.6

9.7 9.0

11.3

8.0

13.7

10.4

30.7

21.2

37.0

33.3

15.0
NCHS Data Brief ■ No. 55 ■ January 2011

■  5  ■

•	 Non-Hispanic white young adults with Medicaid (14%) were more likely to have had unmet 

medical need due to cost than Hispanic young adults with Medicaid (8%). 

•	 Uninsured non-Hispanic white (37%) and non-Hispanic black (33%) young adults were 

more likely to have had unmet medical need than uninsured Hispanic (21%) young adults.

Summary 

Hispanic young adults were less likely than black or white young adults to have health insurance 

coverage. Since coverage affords access to the health care system, it is not surprising that 

Hispanic young adults were less likely than non-Hispanic white or black young adults to have had 

a usual source of medical care or to have had a doctor visit in the past year. 

Insured young adults were more likely than uninsured young adults to have access to the 

medical system and to use medical services. Among insured young adults, approximately equal 

percentages of those within each racial and ethnic group had a usual source of medical care. 

However, among those with private insurance, Hispanic young adults were less likely than 

non-Hispanic white and black young adults to have had a doctor visit in the past year. 

Within each racial and ethnic group, uninsured young adults were about three times as likely as 

those with private insurance to have had unmet medical need. However, the level of unmet need 

varied; uninsured non-Hispanic white (37%) and non-Hispanic black (33%) young adults were 

more likely to have had unmet medical need than uninsured Hispanic (21%) young adults.

This report shows that among young adults aged 20–29 years, there are racial and ethnic 

disparities in health insurance coverage, in the receipt of health care services, and in the level of 

unmet need. The disparities in the receipt of health care services were mitigated to some extent by 

having health insurance coverage. 

Definitions

Terms related to health insurance

Health insurance coverage:	Health	insurance	is	broadly	defined	to	include	both	public	and	private	

payors	who	cover	medical	expenditures	incurred	by	a	defined	population	in	a	variety	of	settings.	

This includes persons covered by private health insurance, whether offered through employment 

or purchased individually, and persons covered by public programs such as Medicare, Medicaid, 

State Children’s Health Insurance Program (CHIP), and other state-sponsored programs. Persons 

with only Indian Health Service coverage or having only a private plan that paid for one type of 

service, such as accidents or dental care, were not considered to be covered by health insurance. 

In this report, coverage is measured at one point in time, which is the day of the National Health 

Interview Survey (NHIS) interview.

Private insurance: Private insurance is indicated when respondents report that they were covered 

by private health insurance through an employer, union, or individual purchase. Private health 

insurance includes managed care such as health maintenance organizations (HMOs). It does not 

include military health plans.
NCHS Data Brief ■ No. 55 ■ January 2011

■  6  ■

Medicaid: Medicaid is indicated when respondents report that they were covered by Medicaid. 

Individuals were also considered covered by Medicaid if they reported coverage by CHIP, or 

other state-sponsored plans. In this analysis, health insurance categories are hierarchical, and 

adults covered by both private insurance and Medicaid were considered to have private insurance. 

Uninsured: Uninsured status is indicated when respondents report that they did not have coverage 

under private health insurance, Medicare, Medicaid, CHIP, another state-sponsored health plan, 

other government-sponsored programs, or a military health plan (TRICARE, VA, or CHAMPVA).	A	person	was	also	defined	as	uninsured	if	he	or	she	had	only	Indian	Health	Service	coverage	

or had only a private plan that paid for one type of service such as accidents or dental care.

Terms related to health care access and utilization

Doctor or other health professional: Doctor refers to medical doctors (MDs) and osteopathic 

physicians (DOs), including general practitioners and all types of specialists (such as internists, 

gynecologists, obstetricians, psychiatrists, and ophthalmologists). Other health care professional 

includes physician assistants, psychologists, nurses, physical therapists, chiropractors, etc.

Doctor or other health care professional contact: This may include a contact while a person 

is in the hospital as well as a contact from a home visit, but not a contact made to arrange 

appointments. 

Emergency room visit: This includes all emergency room visits, even those that resulted in a 

hospital admission.

Unmet need: A person was considered to have unmet need if he or she did not get or delayed 

medical care due to cost in the past year.

Usual source of care: Usual source of care was measured by asking the respondent “Is there a 

place that you USUALLY go when you are sick or need advice about your health?” Persons who 

report	the	emergency	department	as	their	usual	source	of	care	are	defined	as	having	no	usual	

source of care in this report.

Caveat

Most access and utilization measures in this report are based on the 12 months prior to interview, 

with the exception of a usual source of care. Usual source of care is based on a person’s status 

at the time of interview. Insurance coverage is also based on a person’s status at the time of 

interview. Therefore, an individual’s insurance status may have been different at the time health 

services were sought or received. 

Data source and methods

Data from the 2008 and 2009 NHIS were used for this analysis. NHIS data are collected 

continuously throughout the year for the Centers for Disease Control and Prevention’s National 

Center for Health Statistics (NCHS), by interviewers from the U.S. Census Bureau. The 

NHIS collects information about the health and health care of the civilian, noninstitutionalized 

U.S. population. Interviews are conducted in respondents’ homes, but follow-ups to complete 

interviews may be conducted over the telephone. The family component collects information 

on all family members and the sample adult component collects additional data on a randomly 
NCHS Data Brief ■ No. 55 ■ January 2011

■  7  ■

selected adult (the “sample adult”). Questions about health insurance coverage and not getting 

medical care due to cost are asked of family respondents in the family component of the survey. 

Other questions on access and utilization are from the sample adult component. In 2008 and 2009, 

information was collected on a total of 21,218 persons aged 20–29 years from the family core 

component and 8,205 persons aged 20–29 years from the sample adult component of the survey. 

For further information about the NHIS, including the questionnaire, see the NCHS website at: 

http://www.cdc.gov/nchs/nhis.htm.

NHIS is designed to yield a sample representative of the civilian noninstitutionalized population 

of the United States, and this analysis uses weights to produce national estimates. Data 

weighting procedures are described in more detail elsewhere (6). Point estimates and estimates 

of corresponding variances for this analysis were calculated using SUDAAN software (7) to 

account for the complex sample design of the NHIS. The Taylor series linearization method was 

chosen for variance estimation. All estimates shown in this report meet the NCHS standard of 

reliability (relative standard error less than or equal to 30%). Differences between percentages 

were evaluated using two-sided significance tests at the 0.05 level. Terms such as “higher than”

and “less than” indicate statistically significant differences. Terms such as “similar” and “no

difference” indicate that the statistics being compared were not significantly different. Lack of

comment regarding the difference between any two statistics does not necessarily suggest that the 

difference was tested and found to be not significant.

About the authors

Barbara Bloom and Robin A. Cohen are with the Centers for Disease Control and Prevention’s 

National Center for Health Statistics, Division of Health Interview Statistics.

References

1. Agency for Health Care Research and Quality. National Health Disparities Report 2009. 

AHRQ Publication No. 10–0004. Rockville, MD: Agency for Health Care Research and Quality 

2010. Available from: http://www.ahrq.gov/qual/qrdr09.htm.

2. Kriss JL, Collins SR, Mahato B, Gould E, Schoen C. Rite of passage? Why young adults 

become uninsured and how new policies can help, 2008 update. The Commonwealth Fund. Issue 

Brief. 2008.

3. Collins SR. Rising numbers of uninsured young adults: Causes, consequences, and new 

policies. Invited Testimony. Subcommittee on Federal Workforce, Postal Service, and the 

District of Columbia Committee on Oversight and Government Reform United States House of 

Representatives Hearing on “Providing Health Insurance to Young Adults Enrolled as Dependents 

in FEHBP.” 2008.

4. National Center for Health Statistics. Health, United States, 2008: With Special Feature on 

the Health of Young Adults. Hyattsville, MD. 2009.

5. Cohen RA, Bloom B. Access to and utilization of medical care for young adults aged 20–29 

years: United States, 2008. NCHS data brief, no 29. Hyattsville, MD: National Center for Health 

Statistics. 2010.
NCHS Data Brief ■ No. 55 ■ January 2011

6. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and 

estimation for the National Health Interview Survey, 1995–2004. National 

Center for Health Statistics. Vital Health Stat 2(130). 2000.

7. Research Triangle Institute. SUDAAN (Release 9.1). Research Triangle 

Park, NC: Research Triangle Institute. 2004.

Suggested citation

Bloom B, Cohen RA. Young adults seeking 

medical care: Do race and ethnicity matter? 

NCHS data brief, no 55. Hyattsville, MD: 

National Center for Health Statistics. 2011.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

U.S. Department of

Health & Human Services

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

Official Business

Penalty for Private Use, $300

To receive this publication regularly, contact the 

National Center for Health Statistics by

calling 1–800–232–4636

E-mail: cdcinfo@cdc.gov

Internet: http://www.cdc.gov/nchs

First Class mAIL

Postage & Fees Paid 

CDC/NCHS

Permit No. G-284

ISSN 1941-4927 (Print ed.)

ISSN 1941-4935 (Online ed.)

CS219145

T38166 (1/2011)

DHHS Publication No. (PHS) 2011–1209