NCHS Data Brief ■ No. 208 ■ July 2015

Health Care Access and Utilization Among Adults Aged 18–64, 

by Race and Hispanic Origin: United States, 2013 and 2014

Michael E. Martinez, M.P.H., M.H.S.A.; Brian W. Ward, Ph.D.; and Patricia F. Adams

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Key findings

Data from the National 

Health Interview Survey, 

2013 and 2014

● Compared with 2013, 

adults aged 18–64 who were 

uninsured at the time of 

interview decreased in 2014 

for Hispanic (41.1% to 34.1%), 

non-Hispanic white (14.5% 

to 11.5%), non-Hispanic 

black (24.7% to 17.6%), and 

non-Hispanic Asian (16.1% to 

12.1%) adults. 

● Adults aged 18–64 who had 

a usual place to go for medical 

care increased in 2014 for 

Hispanic (69.1% to 73.0%) and 

non-Hispanic white (84.3% to 

85.6%) adults. 

● Adults aged 18–64 who 

had seen or talked to a health 

care professional in the past 

12 months increased in 2014 

for Hispanic (67.5% to 70.1%) 

adults. 

● Adults aged 18–64 who did 

not obtain needed medical care 

due to cost at some time during 

the past 12 months decreased 

in 2014 for Hispanic (9.9% to 

7.6%) and non-Hispanic white 

(7.7% to 7.0%) adults. 

In 2014, U.S. adults could buy a private health insurance plan through the 

Health Insurance Marketplace or state-based exchanges established as part 

of the Affordable Care Act. Moreover, some states opted to expand Medicaid 

coverage to low-income adults. Data from the 2013 and 2014 National 

Health Interview Survey (NHIS) are used to describe recent changes in health 

insurance coverage and selected measures of health care access and utilization 

for adults aged 18–64, by race and Hispanic origin.

Keywords: ethnicity • Affordable Care Act • medical care • National Health 

Interview Survey

Did the percentage of uninsured adults change from 2013 to 

2014 for selected race and Hispanic origin subgroups?

● Compared with 2013, the percentage of adults aged 18–64 who were 

uninsured at the time of interview decreased in 2014 for Hispanic (41.1% 

to 34.1%), non-Hispanic white (14.5% to 11.5%), non-Hispanic black 

(24.7% to 17.6%), and non-Hispanic Asian (16.1% to 12.1%) adults 

(Figure 1). 

Figure 1. Percentage of adults aged 18–64 who were uninsured, by race and Hispanic origin: 

United States, 2013 and 2014

1

Significant difference between 2013 and 2014. 

2

Significantly different from the other three race and Hispanic origin groups in 2013. 

3

Significantly different from the other three race and Hispanic origin groups in 2014.

SOURCE: CDC/NCHS, National Health Interview Survey, 2013 and 2014.

0

10

20

30

40

50 2013 2014

Non-Hispanic

Asian

Non-Hispanic

black

Non-Hispanic

white

Hispanic

1,241.1

3

34.1

1,224.7

3

17.6 1 1 16.1 14.5

11.5 12.1

Percent
NCHS Data Brief ■ No. 208 ■ July 2015

● In 2013 and 2014, Hispanic adults aged 18–64 were the most likely to be uninsured at the 

time of interview. 

● In 2013 and 2014, non-Hispanic white and non-Hispanic Asian adults were the least likely 

to be uninsured.

Did the percentage of adults with a usual place to go for medical 

care change from 2013 to 2014 for selected race and Hispanic origin 

subgroups?

● Compared with 2013, the percentage of adults aged 18–64 who had a usual place to go for 

medical care increased in 2014 for Hispanic (69.1% to 73.0%) and non-Hispanic white 

(84.3% to 85.6%) adults (Figure 2). 

● The percentage of adults aged 18–64 who had a usual place to go for medical care did not 

change significantly between 2013 and 2014 for non-Hispanic black and non-Hispanic 

Asian adults.

● In 2013 and 2014, Hispanic adults aged 18–64 were the least likely to have a usual place to 

go for medical care.

● In 2013 and 2014, non-Hispanic white adults aged 18–64 were the most likely to have a 

usual place to go for medical care.

0

20

40

60

80

100 2013 2014

Hispanic Non-Hispanic white Non-Hispanic black Non-Hispanic Asian

Percent

1,269.1

3

73.0

1,284.3

81.6 82.7

3

85.6

81.4 79.2

Figure 2. Percentage of adults aged 18–64 with a usual place to go for medical care, by race and Hispanic origin:

United States, 2013 and 2014

1

Significant difference between 2013 and 2014. 2

Significantly different from the other three race and Hispanic origin groups in 2013. 3

Significantly different from the other three race and Hispanic origin groups in 2014.

SOURCE: CDC/NCHS, National Health Interview Survey, 2013 and 2014.

■  2  ■
NCHS Data Brief ■ No. 208 ■ July 2015

Did the percentage of adults who had seen or talked to a health care 

professional in the past 12 months change from 2013 to 2014 for selected 

race and Hispanic origin subgroups? 

● Compared with 2013, the percentage of adults aged 18–64 who had seen or talked to a 

health care professional in the past 12 months increased in 2014 for Hispanic adults (67.5% 

to 70.1%) (Figure 3).

● The percentage of adults aged 18–64 who had seen or talked to a health care professional in 

the past 12 months did not change significantly between 2013 and 2014 for non-Hispanic 

white, non-Hispanic black, and non-Hispanic Asian adults.

● In 2013 and 2014, Hispanic adults aged 18–64 were the least likely to have seen or talked to 

a health care professional in the past 12 months. 

● In 2013 and 2014, non-Hispanic white adults aged 18–64 were the most likely to have seen 

or talked to a health care professional in the past 12 months, followed by non-Hispanic 

black adults and then non-Hispanic Asian adults.

0

20

40

60

80

100 2013 2014

Hispanic Non-Hispanic white Non-Hispanic black Non-Hispanic Asian

Percent

1,267.5

3

70.1

2

82.7

2

75.7 3

78.2

3

83.6 3 2 81.3 79.9

Figure 3. Percentage of adults aged 18–64 that had seen or talked to a health care professional in the past 12 months, 

by race and Hispanic origin: United States, 2013 and 2014

1

Significant difference between 2013 and 2014. 2

Significantly different from the other three race and Hispanic origin groups in 2013. 3

Significantly different from the other three race and Hispanic origin groups in 2014.

SOURCE: CDC/NCHS, National Health Interview Survey, 2013 and 2014.

■  3  ■
NCHS Data Brief ■ No. 208 ■ July 2015

■  4  ■

Did the percentage of adults who did not obtain needed medical care due 

to cost change from 2013 to 2014 for selected race and Hispanic origin 

subgroups? 

● Compared with 2013, the percentage of adults aged 18–64 who did not obtain needed 

medical care due to cost at some time during the past 12 months decreased in 2014 for 

Hispanic (9.9% to 7.6%) and non-Hispanic white (7.7% to 7.0%) adults (Figure 4). 

● The percentage of adults aged 18–64 who did not obtain needed medical care due to cost at 

some time during the past 12 months did not change significantly between 2013 and 2014 

for non-Hispanic black and non-Hispanic Asian adults. 

● In 2013, Hispanic and non-Hispanic black adults aged 18–64 were the most likely to not 

obtain needed medical care due to cost at some time during the past 12 months.

● In 2014, non-Hispanic black adults aged 18–64 were the most likely to not obtain needed 

medical care due to cost at some time during the past 12 months. 

● In 2013 and 2014, non-Hispanic Asian adults aged 18–64 were the least likely to not obtain 

needed medical care due to cost at some time during the past 12 months.

Percent

0

2

4

6

8

10

12 2013 2014

Hispanic Non-Hispanic white Non-Hispanic black Non-Hispanic Asian

1

9.9

7.6

7.0

10.7

2

4.9

1,27.7

3

9.9

3

3.8

Figure 4. Percentage of adults aged 18–64 who did not obtain needed medical care due to cost at some time during the 

past 12 months, by race and Hispanic origin: United States, 2013 and 2014

1

Significant difference between 2013 and 2014. 2

Significantly different from the other three race and Hispanic origin groups in 2013. 3

Significantly different from the other three race and Hispanic origin groups in 2014.

SOURCE: CDC/NCHS, National Health Interview Survey, 2013 and 2014.
NCHS Data Brief ■ No. 208 ■ July 2015

■  5  ■

Summary

For all racial and Hispanic origin subgroups examined, there were significant decreases in the 

percentage uninsured in 2014. Insurance can lead to improvements in health care access and 

utilization. Indeed, some improvement was observed for some measures of health care access and 

utilization, especially for Hispanic and non-Hispanic white adults aged 18–64. Relative to 2013, 

Hispanic adults in 2014 were significantly more likely to have a usual place for medical care, 

were more likely to have seen or talked to a health care professional within the past 12 months, 

and were less likely to have not obtained needed medical care due to cost at some time during 

the past 12 months. Relative to 2013, non-Hispanic white adults in 2014 were significantly more 

likely to have a usual place for medical care and were less likely to have not obtained needed 

medical care due to cost at some time during the past 12 months. However, compared with 

2013, non-Hispanic black and non-Hispanic Asian adults in 2014 did not show any significant 

improvement across the selected measures beyond the decline in the percentage uninsured. 

In 2014, Hispanic adults aged 18–64 were still more likely than non-Hispanic adults to have 

difficulty accessing and using health care, based on the measures used in this study. Poorer health 

care access and utilization can lead to poorer health outcomes and higher disease prevalence, 

which have sometimes been observed for Hispanic adults relative to non-Hispanic white adults 

(1–3). 

Definitions

Uninsured: A person was categorized as uninsured if he or she did not have any private health 

insurance, Medicare, Medicaid, Children’s Health Insurance Program, state-sponsored or other 

government-sponsored health plan, or military plan at the time of interview. A person was also 

categorized 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. The analyses 

excluded persons with unknown health insurance status (about 1% of respondents each year).

Usual place to go for medical care: Based on a question that asked, “Is there a place that you 

usually go to when you are sick or need advice about your health?” If there was at least one 

such place, then a follow-up question was asked, “What kind of place [is it/do you go to most 

often]—a clinic, doctor’s office, emergency room, or some other place?” Adults who indicated 

that the emergency room was their usual place for care were considered not to have a usual place 

for health care.

Seen or talked to a health care professional in the past 12 months: Based on combined responses 

of “6 months or less” and “more than 6 months, but not more than 1 year ago” to the survey 

question, “About how long has it been since you last saw or talked to a doctor or other health care 

professional about your own health? Include doctors seen while a patient in a hospital.” 

Did not obtain needed medical care due to cost in the past 12 months: Based on a question that 

asked, “During the past 12 months, was there any time when [person] needed medical care, but 

did not get it because [person] couldn’t afford it?” Responses exclude dental care.
NCHS Data Brief ■ No. 208 ■ July 2015

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Data source and methods

Data from the 2013 and 2014 NHIS were used for this analysis. NHIS is a multipurpose health 

survey conducted continuously throughout the year by the Centers for Disease Control and 

Prevention’s (CDC) National Center for Health Statistics (NCHS). Interviews are conducted in 

person in respondents’ homes, but follow-ups to complete interviews may be conducted over the 

telephone. Questions about health insurance coverage and not obtaining needed medical care are 

from the survey’s Family Core component, while questions about a usual place to go for medical 

care and having seen or talked to a health care professional in the past 12 months are from 

the Sample Adult component. The Family Core component collects information on all family 

members, and the Sample Adult component collects additional data from one randomly selected 

adult (the sample adult). For more information about NHIS, including the questionnaire, visit the 

NHIS website at: http://www.cdc.gov/nchs/nhis.htm.

All analyses used weights to produce national estimates. Data weighting procedures are described 

elsewhere (4). Point estimates and their estimated variances were calculated using SUDAAN 

software (5) and the Taylor series linearization method to account for the complex design 

of NHIS. Two-sided significance tests at the 0.05 level were used to compare estimates. All 

estimates shown in this report meet the NCHS standard of reliability (relative standard error less 

than or equal to 30%).

About the authors

Michael E. Martinez, Brian W. Ward, and Patricia F. Adams are with CDC’s National Center for 

Health Statistics, Division of Health Interview Statistics.
NCHS Data Brief ■ No. 208 ■ July 2015

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References

1. Ward BW, Clarke TC, Freeman G, Schiller JS. Early release of selected estimates based on 

data from the 2014 National Health Interview Survey. National Center for Health Statistics. June 

2015. Available from: http://www.cdc.gov/nchs/nhis/releases.htm.

2. Cohen RA, Martinez ME. Health insurance coverage: Early release of estimates from the 

National Health Interview Survey, 2014. National Center for Health Statistics. June 2015. 

Available from: http://www.cdc.gov/nchs/nhis/releases.htm.

3. Dominguez K, Penman-Aguilar A, Chang MH, Moonesinghe R, Castellanos T, RodriguezLainz A, Schieber R. Vital signs: Leading causes of death, prevalence of diseases and risk 

factors, and use of health services among Hispanics in the United States—2009–2013. MMWR 

64(17):469–478. 2015.

4. Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health 

Interview Survey, 2006–2015. National Center for Health Statistics. Vital Health Stat 2(165). 

2014.

5. RTI International. SUDAAN (Release 11.0.0) [computer software]. 2012. 
NCHS Data Brief ■ No. 208 ■ July 2015

Suggested citation

Martinez ME, Ward BW, Adams PF. Health 

care access and utilization among adults 

aged 18–64, by race and Hispanic origin: 

United States, 2013 and 2014. NCHS data 

brief, no 208. Hyattsville, MD: National 

Center for Health Statistics. 2015.

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

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Marcie L. Cynamon, Director

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