Medical Expenditure Panel Survey B

MEPS Chartbook No. 14 • Medical Expenditure Panel Survey

Racial and Ethnic Differences in

Health Insurance Coverage and

Usual Source of Health Care, 2002

Advancing Excellence in Health Care • www.ahrq.gov

Agency for Healthcare Research and Quality
MEPS Chartbook No. 14

by Michelle Roberts, B.A.

Suggested citation:

Roberts M. Racial and ethnic differences in health insurance coverage and usual source of health care, 2002. Rockville

(MD):Agency for Healthcare Research and Quality; 2006. MEPS Chartbook No. 14. AHRQ Pub. No. 06-0004.

The estimates in this report are based on the most recent data available from MEPS at the time the report was written.

However, selected elements of MEPS data may be revised on the basis of additional analyses, which could result in slightly

different estimates from those shown here. Please check the MEPS Web site for the most current file releases—

www.meps.ahrq.gov

The mission of AHRQ is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans by:

• Using evidence to improve health care.

• Improving health care outcomes through research.

• Transforming research into practice.
This report presents estimates of health insurance coverage

and usual source of health care services during 2002 for

Hispanic, non-Hispanic white, non-Hispanic black, nonHispanic Asian, and other single/multiple race nonHispanic Americans. Definitions of the racial and ethnic

groups are shown on page 29. Since “Hispanic” is an ethnic

designation, Hispanics can be of any race. Key findings

include the following.

Health Insurance Coverage

• Among Americans under age 65, Hispanics were almost

three times as likely as non-Hispanic whites to be

uninsured during 2002. 

• Young non-Hispanic white and non-Hispanic Asian

women were more likely to have private insurance

coverage than young Hispanic and non-Hispanic black

women.

• Hispanic workers were the least likely to have jobrelated health insurance coverage.

Usual Source of Health Care

• In 2002, Hispanics (32.8%), non-Hispanic Asians

(27.1%), and non-Hispanic blacks (20.9%) were all more

likely than non-Hispanic whites (15.2%) to lack a usual

source of care.

• More than a third of Cuban Americans, Mexican

Americans, and Hispanics in the “other” category (other

than Puerto Rican, Cuban, or Mexican American)

lacked a usual source of health care.

• Both Hispanic children and non-Hispanic Asian children

were more than twice as likely as non-Hispanic white

children to lack a usual source of care in 2002. 

Medical Expenditure Panel Survey i

Executive Summary

The mission of the Agency for Healthcare Research and

Quality (AHRQ) is to improve the quality, safety, efficiency,

and effectiveness of health care for all Americans. The

Medical Expenditure Panel Survey (MEPS) helps AHRQ

fulfill its mission by providing information on health care

use and expenses, health insurance, health status, and a

variety of demographic, social, and economic characteristics.

MEPS is a set of large-scale surveys of families and

individuals, their medical providers, and employers across

the United States. 

MEPS provides various ways of accessing the data so that it

can be most useful to you. The MEPS Web site,

www.meps.ahrq.gov, has:

• Online publications to read or download.

• MEPS public use data files that you can review and

download.

• MEPSNet, which allows analysis of MEPS data using

online statistical tools.

• Tables showing MEPS data displayed by some of the

most frequently used characteristics.

AHRQ welcomes questions and comments from readers of

this publication who are interested in obtaining more

information about access, cost, use, financing, and quality of

health care in the United States. We also invite you to tell

us how you are using this Chartbook and other MEPS data

and tools and to share suggestions on how MEPS products

might be enhanced to further meet your needs. Please 

e-mail us at mepspd@ahrq.gov or send a letter to the

address below:

Steven B. Cohen, Ph.D.

Director

Center for Financing, Access, and Cost Trends

Agency for Healthcare Research and Quality

540 Gaither Road

Rockville, MD 20850

Medical Expenditure Panel Survey iii

Foreword

Introduction........................................................................................................................................1

Source of Data for This Report...........................................................................................................3

Section 1:

Health Insurance Coverage...........................................................................................................5

Section 2:

Usual Source of Health Care ......................................................................................................17

References .........................................................................................................................................27

Definition of Terms...........................................................................................................................29

Medical Expenditure Panel Survey v

Contents

Despite technological advancements that have led to

improvements in the overall quality of health for Americans,

substantial differences in health remain between racial and

ethnic groups. These differences have become the focus of a

growing body of health services research and a considerable

amount of public policy attention. 

As a part of an annual report series, the 2005 National

Healthcare Disparities Report (Agency for Healthcare

Research and Quality, 2005) tracks disparities and gaps in

the U.S. health care system. A major component of the

2005 report, as well as the 2004 and 2003 reports, is that

people need to gain entry into the system before they can

receive needed care. This chartbook examines two features

of gaining entry into the U.S. health care system: health

insurance coverage and usual source of care. Furthermore, 

the 2005 Healthcare Disparities Report examines priority

populations as specified by Congress in the Healthcare

Research and Quality Act of 1999. This chartbook takes

one priority population, racial and ethnic minority groups,

and investigates differences in health insurance coverage and

usual sources of care for those groups with respect to such

demographic characteristics as gender, age, income, and

minority subpopulation. 

The chartbook is organized into two sections. The first

section compares health insurance status for racial and

ethnic groups, including differences in job-related health

insurance. The second section addresses differences in usual

sources of care among racial and ethnic groups. 

Medical Expenditure Panel Survey 1

Introduction

The estimates presented in this report come from the

Medical Expenditure Panel Survey (MEPS). MEPS is a

nationally representative survey of households, collecting

detailed information on health status, health care use and

expenses, and health insurance coverage of individuals and

families in the U.S. civilian noninstitutionalized population. 

Data for this chartbook come from MEPS public use file

HC-070, the 2002 Full Year Consolidated Data File.

In some cases, totals may not add precisely to 100 percent

because of rounding. In addition, because MEPS is based

on a complex sample design, survey estimates are subject to

statistical sampling error. Differences that appear large may

not be statistically significant. Thus, only differences

between groups that are statistically significant at the 0.05

level (not likely to be caused by sampling error) are noted

in the text.

Medical Expenditure Panel Survey 3

Source of Data for This Report

Health insurance plays a critical role in ensuring that

Americans get into the health care system to obtain timely

medical care and have protection against expensive health

care costs. This section looks at the status of health

insurance coverage for a variety of racial and ethnic groups

during 2002. 

MEPS divides health insurance coverage into three

categories: 

• People classified as “any private” had private health

insurance at some time during 2002.

• People who had no private coverage during 2002 but

who had public insurance such as Medicaid or Medicare

at any time during the year are described as “public

only.”

• People who did not have private or public insurance at

any time during 2002 are identified as “uninsured.”

Demographic characteristics, such as Hispanic

subpopulations, gender, age, and income level, are also

examined here.

Finally, since employers are the most common source of

private health insurance coverage in the United States, this

section explores differences arising from job-related health

insurance coverage. 

Medical Expenditure Panel Survey 5

Section 1: Health Insurance Coverage
During 2002, 13.3% of Americans

under age 65 were uninsured for the

entire year. Hispanics were the

racial/ethnic group most likely to be

uninsured. Approximately 28.0% of

Hispanics (10.4 million) lacked any type

of health insurance all year.

• Hispanics were almost three times as

likely as non-Hispanic whites, 2.5

times as likely as non-Hispanic

Asians, and twice as likely as nonHispanic blacks and other

single/multiple race non-Hispanic

Americans to lack health insurance

coverage during 2002.

• Non-Hispanic whites and nonHispanic Asians under age 65 were

more likely to have private health

insurance coverage than the other

groups. About four-fifths of nonHispanic whites and non-Hispanic

Asians had private health insurance,

compared to percents ranging from

48.2% to 64.5% for the other

groups.

• With coverage rates ranging from

21.7% to 27.5%, Hispanics, nonHispanic blacks, and other

single/multiple race non-Hispanic

Americans under age 65 were more

likely to be covered by public health

insurance than non-Hispanic whites

(8.8%) and non-Hispanic Asians

(9.6%).

6 Medical Expenditure Panel Survey

Who has coverage and who does not? 

Other single/multiple

race non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

All racial/ethnic groups

Any private insurance Uninsured Public insurance only

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

48.2

73.0

81.2

59.0

figure 1

28.0

13.3 10.0 13.5

Under age 65

79.0

64.5

11.4 13.8

23.9

13.7

8.8

27.5

9.6

21.7
Uninsured rates were about the same

for Cuban, Mexican, and other Hispanic

Americans under age 65 during 2002.

• Each Hispanic subgroup except

Puerto Ricans had similar rates of

uninsurance, ranging from 27.0% to

30.2%.

• In 2002, 3 out of 10, or 7.5 million,

Mexican Americans under age 65

were uninsured.

• Within the Hispanic subpopulations,

Puerto Ricans under age 65 were

the least likely to be uninsured

during 2002 (only 14.8%). 

• More than a third of Puerto Ricans

had only public health care coverage

during the year.

• Less than one-half of all Cuban and

Mexican Americans had private

health insurance at any time during

2002.

Medical Expenditure Panel Survey 7

How does coverage differ among the 

Hispanic subpopulations?

Other Hispanic

Mexican

Cuban

Puerto Rican

All Hispanics

Any private insurance Uninsured Public insurance only

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

51.0 48.2 49.4 46.3

figure 2

14.8

28.0 27.0 30.2

Hispanics under age 65

52.6

27.6

34.2

23.9 23.6 23.4 19.9
In both low-tier and high-tier income

categories, Hispanics under age 65 were

most likely to be uninsured. 

Low-tier income category:

• More than one out of three

Hispanics under age 65 lacked any

type of health insurance coverage

during 2002.

• Non-Hispanic whites, non-Hispanic

Asians, and other single/multiple

race non-Hispanics were the most

likely to have private health

insurance coverage.

High-tier income category:

• About one out of five Hispanics

were uninsured during 2002. 

• Hispanics were almost three times as

likely as non-Hispanic whites, 2.6

times as likely as non-Hispanic

Asians, and twice as likely as nonHispanic blacks and other

single/multiple race non-Hispanics

to be uninsured for all of 2002.

8 Medical Expenditure Panel Survey

Does income affect the types of coverage held

by racial/ethnic groups?

All income groups

All low-tier income

Hispanic

Non-Hispanic white

Non-Hispanic black

Non-Hispanic Asian

Other single/multiple race non-Hispanic

figure 3

Under age 65

10%

All high-tier income

Hispanic

Non-Hispanic white

Non-Hispanic black

Non-Hispanic Asian

Other single/multiple race non-Hispanic

0% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Any private insurance Uninsured Public insurance only

73.0 13.7 13.3

Low-tier income High-tier income

37.7 37.9 24.4

26.7 38.4 35.0

46.2 32.1 21.8

30.6 51.2 18.2

44.9 32.7 22.5

39.4 41.3 19.3

87.7 8.6 3.7

20.5 8.3

90.5 6.9 2.6

83.8 6.7 9.5

89.7 7.9 2.4

81.8 8.1 10.0

71.2

Note: Low-tier income—poor/near poor/low income.

 High-tier income—middle/high income.
Among females under 65, Hispanics

were the most likely to be uninsured,

non-Hispanic black females were the

most likely to have public coverage, and

non-Hispanic white and non-Hispanic

Asian females were the most likely to

have private health insurance coverage.

• One-quarter of all Hispanic females

under 65 were uninsured in 2002.

Hispanic females were almost three

times as likely as non-Hispanic white

females to be uninsured.

• More than three out of four nonHispanic white and non-Hispanic

Asian females were covered by

private health insurance.

• Non-Hispanic black, Hispanic, and

other single/multiple race females

were the most likely to have public

health insurance coverage. 

Medical Expenditure Panel Survey 9

How does coverage vary among females of

different racial/ethnic groups?

figure 4

Any private insurance Uninsured Public insurance only

Both sexes All females Hispanic Non-Hispanic

 white

Non-Hispanic

 black

Non-Hispanic

 Asian

Other single/

multiple race

non-Hispanic

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

13.3

13.7

73.0

58.7

11.3

30.1

Under age 65

9.7

23.8 11.2

79.1

12.0

64.2

11.8

15.3

72.9

47.7

26.9

25.4

9.0

9.9

81.2

Females
Hispanic males were more likely to be

uninsured (30.4%) than to have public

insurance (21.0%). 

• In 2002, roughly 6 million Hispanic

males under age 65 were uninsured.

They were almost three times as

likely as non-Hispanic white males

to lack health insurance coverage. 

• Hispanic males under 65 were more

likely to be uninsured than to have

public health insurance coverage. 

• Less than one-half of Hispanic males

under age 65 had private health

insurance coverage (48.6%); they

were the group least likely to have

private health insurance.

• Non-Hispanic white and nonHispanic Asian males under 65 were

the most likely to have private

insurance (about four-fifths of each

group).

10 Medical Expenditure Panel Survey

How does insurance vary among males of

different racial/ethnic groups?

figure 5

Any private insurance Uninsured Public insurance only

Both sexes All males Hispanic Non-Hispanic

 white

Non-Hispanic

 black

Non-Hispanic

 Asian

Other single/

multiple race

non-Hispanic

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

13.3

13.7

73.0

59.3

16.1

24.6

Under age 65

9.5

19.5

11.6

78.9

15.7

64.9

14.8

12.1

73.0

48.6

21.0

30.4

11.1

7.7

81.2

Males
Rates of public health insurance

coverage did not significantly differ

between Hispanic and non-Hispanic

black children (44.1% and 48.6%,

respectively) during 2002.

• Hispanic children were the most

likely to be uninsured. They were

three times as likely as non-Hispanic

black children and more than twice

as likely as non-Hispanic white

children or other single/multiple

race non-Hispanic children to lack

any type of health insurance.

• Less than half of Hispanic and nonHispanic black children had private

insurance, compared to 77.3% of

non-Hispanic white, 74.6% of nonHispanic Asian, and 60.5% of other

single/multiple race non-Hispanic

children.

Medical Expenditure Panel Survey 11

Are children in certain racial/ethnic groups

more likely to be uninsured?

figure 6

Any private insurance Uninsured Public insurance only

All children Hispanic Non-Hispanic

white

Non-Hispanic

black

Non-Hispanic

Asian

Other single/

multiple race

non-Hispanic

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

7.7

27.0

65.3

46.7

4.8

48.6

Children under age 18

17.3

33.9

8.1

74.6

5.6

60.5

15.0

44.1

40.9

77.3

16.5

6.2
Almost one-half of all young Hispanic

men ages 18-24 (46.8%) lacked any type

of health insurance coverage, compared

to 17.3% of young adult non-Hispanic

Asian men and 19.7% of young adult

non-Hispanic white men.

• Young Hispanic men were 4.5 times

as likely to be uninsured as to have

public health insurance coverage.

• More than one-quarter of young

non-Hispanic black men were

uninsured. 

• More than one out of four young

Hispanic and non-Hispanic black

women had public insurance

coverage.

• One-third of all young Hispanic

women were uninsured.

• Young non-Hispanic white and nonHispanic Asian females were more

likely to have private insurance

coverage than young Hispanic and

non-Hispanic black women.

• All young men ages 18-24 were

more likely to be uninsured (26.2%)

than to have public health insurance

coverage (6.8%).

12 Medical Expenditure Panel Survey

Does health coverage differ among young

adults by race/ethnicity? 

figure 7

Any private insurance Uninsured Public insurance only

Men Women Men Women Men Women Men Women Men Women Men Women

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

26.2

6.8

67.0

Young adults ages 18-24

All young adults Hispanic Non-Hispanic

white

Non-Hispanic

black

Non-Hispanic

Asian

Other single/

multiple race

non-Hispanic

19.0

16.1

64.9

46.8

10.4

42.8

33.8

27.2

39.0

19.7

3.7

76.6

15.0

10.6

74.4

28.5

14.9

56.6

17.3

12.8

70.0

14.9

11.8

73.3

37.7

7.9

54.4

19.1

27.7

53.2

25.1

18.7

56.3
Non-Hispanic white and non-Hispanic

Asian workers were the most likely to

have job-related health insurance

coverage in 2002.

• More than four-fifths of nonHispanic white and non-Hispanic

Asian workers had job-related health

insurance.

• Hispanic workers were the least

likely to have job-related health

insurance coverage; only 57.5% had

employer-sponsored insurance.

Medical Expenditure Panel Survey 13

Does job-related health coverage differ by

race/ethnicity?

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

81.0

72.1

81.6

68.4

figure 8

57.5

76.8

All workers

ages 16-64

Hispanic Non-Hispanic

white

Non-Hispanic

black

Non-Hispanic

Asian

Other single/

multiple race

non-Hispanic

Workers ages 16-64 with job-related health insurance
Rates of job-related health insurance did

not significantly differ for Cuban

Americans, Mexican Americans, and

other Hispanic workers during 2002. 

• 52.8% of Cubans, 55.9% of

Mexicans, and 58.9% of other

Hispanic workers had job-related

health insurance coverage.

• Two-thirds of Puerto Rican workers

had job-related coverage, compared

to slightly more than one-half of

Mexican American workers.

14 Medical Expenditure Panel Survey

Does job-related health coverage differ among

the Hispanic subpopulations?

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

52.8 55.9 58.9

figure 9

66.6

57.5

All Hispanic

workers

ages 16-64

Puerto Rican Cuban Mexican Other

Hispanic

Hispanic workers ages 16-64 with job-related health insurance
During 2002, male Hispanic workers

were the group least likely to have

health coverage from an employer. 

• Among employed males, slightly

more than half of Hispanics (54.6%)

had job-related coverage, compared

to about 8 out of 10 for nonHispanic whites and non-Hispanic

Asians and 7 out of 10 for nonHispanic blacks and other

single/multiple race non-Hispanics.

• Female Hispanic workers were more

likely than Hispanic male workers to

have job-related coverage.

• Among employed females, about 8

out of 10 non-Hispanic whites and

non-Hispanic Asians had job-related

coverage, compared to rates of 6 to

7 out of 10 for Hispanics, nonHispanic blacks, and other

single/multiple race non-Hispanics. 

Medical Expenditure Panel Survey 15

What gender differences exist in job-related

health coverage among racial/ethnic groups? figure 10

All workers

ages 16-64

Hispanic Non-Hispanic

white

Non-Hispanic

black

Non-Hispanic

Asian

Other single/

multiple race

non-Hispanic

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

75.9

Workers ages 16-64 with job-related health insurance

77.8

54.6

61.5

80.7 81.3

71.0

80.9 82.2

54.4

73.0

56.3

Men Women

69.4 67.5
Among poor, near poor, and

low-income workers, Hispanics

were the least likely to have jobrelated health insurance coverage

during 2002. 

• Among low-tier income

workers, 34.7% of Hispanics

had insurance from their

employer, compared to rates

of 44.1% to 52.1% for the

remaining racial/ethnic

groups.

• Among high-tier income

workers, 72.9% of Hispanic

workers had job-related

health insurance, compared to

rates of 84.7% to 87.8% for

the remaining racial/ethnic

groups.

16 Medical Expenditure Panel Survey

Are there income-related differences in job-related

health coverage among racial/ethnic groups? figure 11

Workers ages 16-64 with job related health insurance

All hightier income

Hispanic

Non-Hispanic

white

Non-Hispanic black

Non-Hispanic

Asian

Other single/

multiple race

non-Hispanic

44.5

34.7

48.8

44.1

52.1

45.1

85.2

72.9

86.8 84.7 87.8

79.0

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

All low

tier income

Hispanic

Non-Hispanic

white

Non-Hispanic black

Non-Hispanic

Asian

Other single/

multiple race

non-Hispanic

Low-tier income High-tier income

Note: Low-tier income—poor/near poor/low income.

 High-tier income—middle/high income.
Having adequate access to health care services can

significantly influence health care use and health outcomes.

One way to measure access to care is to ask whether people

have a usual source of care—that is, ask people whether they

have a person or place they usually go to if they are sick or

in need of advice about their health. Lacking a usual source

of care may also have important implications for the quality

and continuity of care received. Studies have shown that

people who do not have a usual source of care reduce their 

chances to receive necessary health care services, which can

result in poor health outcomes (DeVoe, Fryer, Philips, et

al., 2003). In addition, people without a usual source of

health care are less likely to obtain a variety of preventive

health care services (Weinick, Zuvekas, and Drilea, 1997). 

This section describes racial and ethnic differences in usual

source of care for 2002.

Medical Expenditure Panel Survey 17

Section 2: Usual Source of Health Care
In 2002, Hispanics (32.8%), nonHispanic Asians (27.1%), and nonHispanic blacks (20.9%) were all more

likely than non-Hispanic whites (15.2%)

to lack a usual source of care.

• Nearly a third of Hispanics did not

have a usual source of care. They

were the racial/ethnic group most

likely to be without a usual source of

health care.

• Almost three-fourths of nonHispanic whites had an office-based

source of health care, compared to

slightly more than half of Hispanics.

• Non-Hispanic blacks, Hispanics, and

other single/multiple race nonHispanics were more likely than

non-Hispanic whites to have a

hospital-based source of care.

18 Medical Expenditure Panel Survey

Are some racial/ethnic groups more likely to

lack a usual source of care?

Other single/multiple

race non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

Total

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

51.4

68.0

72.9

62.6

figure 12

15.9 13.2 11.9

16.6

All ages

59.6 62.6

13.2

18.8

32.8

18.8

15.2

20.9

27.1

18.6

Usual source of health care
More than a third of Cuban Americans,

Mexican Americans, and other

Hispanics did not have a usual source of

health care.

• 37.4% of Cubans, 34.1% of

Mexicans, and 34.4% of other

Hispanics did not have a usual

source of health care.

• Puerto Ricans were the least likely to

lack a usual source of health care

(19.7%). 

Medical Expenditure Panel Survey 19

What differences exist among the Hispanic subpopulations regarding a usual source of health care?

Other Hispanic

Mexican

Cuban

Puerto Rican

All Hispanics

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

59.0

51.4 52.2 50.7

figure 13

21.4

15.9

10.4

Hispanics, all ages

49.4

15.2 16.2 19.7

32.8

37.4 34.1 34.4

Usual source of health care
In the low-tier income category,

Hispanics were the most likely to lack a

usual source of care. 

• In 2002, among people in the lowtier income category, more than one

in three Hispanics did not have a

usual source of care. In comparison,

20.0% to 26.8% of other groups

with low income lacked a usual

source of care.

• In this income category, Hispanics

also were the least likely to have an

office-based source of medical care.

Less than half of Hispanics in the

low-tier income category had an

office-based source of care,

compared to more than two-thirds

of non-Hispanic whites.

20 Medical Expenditure Panel Survey

Are there racial/ethnic differences in usual source of

medical care for people in the low-tier income group?

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

46.8

59.8

67.0

57.7

figure 14

15.7 16.5 13.1

20.6

All ages, low-tier income

56.3 54.5

16.9

22.1

36.7

24.5

20.0 21.7

26.8

23.4

Usual source of health care

Other single/multiple

race non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

Total

Note: Low-tier income—poor/near poor/low income.
Hispanics and non-Hispanic Asians in

the high-tier income group were the

most likely to lack a usual source of care

in 2002. 

• 28.6% of Hispanics and 27.2% of

non-Hispanic Asians in the high-tier

income category had no specific

source or place to receive ongoing

health care services.

• Among those in the high-tier

income category, Hispanics were the

least likely to have an office-based

source of health care (56.3%).

Medical Expenditure Panel Survey 21

Are there racial/ethnic differences in usual source

of care for people in the high-tier income group? 

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

56.3

71.5

74.7

67.1

figure 15

15.2 12.2 11.6 12.8

All ages, high-tier income

60.7

68.5

12.1

16.4

28.6

16.3 13.7

20.1

27.2

Usual source of health care

Other single/multiple

race non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

Total

Note: High-tier income—middle/high income.

15.2
Hispanic and non-Hispanic Asian

women were the most likely to lack a

usual source of care in 2002. 

• 33.2% of Hispanic women and

31.4% of non-Hispanic Asian

women ages 18-64 did not report a

usual source of care to obtain

ongoing health services.

• Non-Hispanic white women were

the most likely to have an officebased source of health care; almost

three-fourths of them received their

usual health care service in an office

setting.

22 Medical Expenditure Panel Survey

Are there racial/ethnic differences among

women related to usual source of care?

Other single/multiple race

non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

All women

Both sexes

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

50.2

67.0

72.0

61.5

figure 16

16.6

13.4 12.2

16.6

Ages 18-64

56.3

61.0

12.3

18.7

33.2

19.6

15.8

22.0

31.4

Usual source of health care

20.3

Women

62.2

12.9

24.8
Hispanic men were the most likely to

lack a usual source of care and the least

likely to have an office-based source of

care in 2002.

• More than one-half of Hispanic men

ages 18-64 had no usual source of

care.

• Hispanic men were twice as likely as

non-Hispanic white men to be

without a usual source of health

care.

• Hispanic men were the least likely

and non-Hispanic white men were

the most likely to have an officebased source of care.

• The percent of men whose usual

source of care was hospital based did

not vary significantly by

racial/ethnic group.

Medical Expenditure Panel Survey 23

Are there racial/ethnic differences among men

related to having a usual source of care?

Other single/multiple race

non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

All men

Both sexes

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

36.5

57.3

63.2

50.9

figure 17

12.4 12.1 12.1 13.3

Ages 18-64

51.0 48.2

14.1

18.0

51.5

30.2

24.7

35.7 34.9

Usual source of health care

33.8

Men

62.2

12.9

24.8
Both Hispanic children and nonHispanic Asian children were more than

twice as likely as non-Hispanic white

children to lack a usual source of care in

2002. 

• Both Hispanic children and nonHispanic Asian children were less

likely than non-Hispanic white

children to have an office-based

usual source of care. 

• In 2002, Hispanic children and nonHispanic black children were more

likely than non-Hispanic white

children to have a hospital-based

source of care.

24 Medical Expenditure Panel Survey

Are children in some racial/ethnic groups

more likely to lack a usual source of care?

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

64.2

76.0

80.9

72.5

figure 18

17.8 14.0

11.9

17.0

Children under age 18

70.6 72.9

13.4

18.4 18.0

10.0 7.1 10.5

16.0

Usual source of health care

Other single/multiple

race non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

All children

8.7
Half of all young Hispanic adults lacked

a usual source of care in 2002. 

• Among young adults ages 18-24,

Hispanics were almost twice as likely

as non-Hispanic whites to lack a

specific source of ongoing health

care services.

• Young adults did not differ

significantly by racial/ethnic group

in their use of hospitals as a usual

source of health care services.

Medical Expenditure Panel Survey 25

Does usual source of care differ for 

young adults?

Office-based Hospital-based None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

38.9

53.3

59.3

47.8

figure 19

11.7 11.0 11.9 11.3

Young adults ages 18-24

49.3

42.2

12.8 14.1

50.1

34.9

28.8

40.9 37.9

Usual source of health care

Other single/multiple

race non-Hispanic

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

All young adults

43.7

Agency for Healthcare Research and Quality. 2005 National

Healthcare Disparities Report. Rockville (MD): Department

of Health and Human Services; Agency for Healthcare

Research and Quality; Dec 2005. AHRQ Pub. No. 06-0017.

Cohen S. Design strategies and innovations in the Medical Care

Expenditure Panel Survey. Medical Care 2003 (Jul); 41(7

Suppl): :III5–III12. 

DeVoe JE, Fryer GE, Phillips R, et al. Receipt of preventive care

among adults: insurance status and usual source of care.

American Journal of Public Health 2003 (May); 93:786–91.

Kass BL, Weinick RM, Monheit AC. Racial and ethnic differences

in health, 1996. Rockville (MD): Agency for Health Care

Policy and Research; 1999. MEPS Chartbook No. 2. AHCPR

Pub. No. 99-0001.

Weinick RM, Zuvekas SH, Drilea SK. Access to health care—

sources and barriers, 1996. Rockville (MD): Agency for

Health Care Policy and Research; 1997. MEPS Research

Findings No. 3. AHCPR Pub. No. 98-0001.

Medical Expenditure Panel Survey 27

References

Race/ethnicity 

Comparisons by racial/ethnic groups in this chartbook are

based on the following five race/ethnicity groups: nonHispanic whites, non-Hispanic blacks, non-Hispanic Asians,

other single/multiple race non-Hispanics, and Hispanics (of

any race). The other single/multiple race non-Hispanic

category includes American Indians, Aleutian Islanders,

Eskimos, and any other unspecified races. While the health

experience of these groups in the other category is of

interest, MEPS samples too few individuals to present

reliable data on them. In addition, beginning in 2002,

MEPS respondents had the option of reporting multiple

races. These persons were also included in the other

single/multiple race non-Hispanic category. 

Race and ethnicity classifications were determined from

information reported for each family member. Respondents

were asked if each family member’s race was best described

as American Indian, Alaska Native, Asian or Pacific Islander,

black, white, or other. They also were asked if each family

member’s main national origin or ancestry was Puerto

Rican; Cuban; Mexican, Mexicano, Mexican American,

Chicano; other Latin American; or other Spanish. All

persons whose main national origin or ancestry was

reported in one of these Hispanic groups, regardless of

racial background, were classified as Hispanic. Since the

Hispanic grouping can include black Hispanics, white

Hispanics, Asian and Pacific Islander Hispanics, and other

Hispanics, the race categories of black, white, Asian, and

other do not include Hispanics. 

Health insurance status

The health insurance information in this chartbook is for

coverage during 2002. Respondents were asked about

health insurance coverage for themselves and all household

members at each round of interviewing. The insurance

variables reflect coverage for hospital and physician services. 

Any private insurance category includes those who at any

time during 2002 had any private insurance coverage,

including TRICARE/VA (which covers retired members of

the Uniformed Services and the spouses and children of

active-duty military). In this chartbook, private health

insurance coverage also includes individual or group plan

coverage for medical or related expenses and prepaid health

plans such as health maintenance organizations. It excludes

extra-cash coverage plans, medical benefits linked only to

specific diseases (dread disease plans), and casualty benefit

plans (such as automobile insurance). 

Medical Expenditure Panel Survey 29

Definition of Terms
Public insurance only includes persons who were never

covered by private insurance during 2002 but who were

covered at any time by Medicare, Medicaid, or other State

and local medical assistance programs.

Uninsured comprises all persons with neither public nor

private insurance coverage at any time during 2002. 

Income categories

Income categories were determined by the ratio of family

income to the Federal poverty threshold for 2002, which

varies by family size and age of head of family. The two

income categories in the chartbook are defined as follows:

Low-tier or poor, near poor, and low income category includes

persons in families with incomes less than or equal to 200%

of the poverty line.

High-tier or middle and high income category includes

persons in families with incomes over 200% of the poverty

line.

Usual source of care 

For each individual family member, MEPS ascertains

whether there is a particular doctor’s office, clinic, health

center, or other place that the individual usually goes to if

he/she is sick or needs advice about his/her health.

30 Medical Expenditure Panel Survey

Medical Expenditure Panel Survey A

AHRQ Publication No. 06-0004

March 2006

ISBN 1-58763-260-8

ISSN 1531-5649

U.S. Department of Health and Human Services

Public Health Service

Agency for Healthcare Research and Quality

540 Gaither Road

Rockville, MD 20850