Health Department Releases Data on Insurance Status and Access to Care for Immigrants in New York City

Percentage of foreign-born adults without insurance decreased by 30 percent from 2013 to 2014

Still, foreign-born adults were less likely than U.S-born adults to receive routine preventive services in the past 12 months

July 20, 2016 – The Health Department today released a Vital Signs report examining access to preventive and primary health care among immigrants in New York City. Nearly half of New York City adults, originating from more than 154 countries worldwide, report being foreign-born. Most of the city’s foreign-born residents have lived in NYC for more than 10 years. Acquiring health insurance remains a challenge for many immigrants, especially for those who are unauthorized (often referred to as undocumented). While insurance does not guarantee access to care, it does help facilitate care and can increase the use of preventive services.

In 2014, foreign-born adults were less likely than U.S.-born adults to receive certain routine preventive services in the past 12 months, such as having their blood pressure checked (85 percent vs. 92 percent) or receiving a flu shot (41 percent vs. 46 percent). Since the implementation of the Affordable Care Act, the percentage of foreign-born adults without insurance decreased from 30 percent in 2013 to 21 percent in 2014. Still, foreign-born adults remain less likely than U.S.-born adults to have health insurance. Furthermore, foreign-born adults who report having certain health conditions are less likely to be insured than US-born adults. For example, 19 percent of foreign-born adults with hypertension – a leading risk factor for heart attack and stroke – were uninsured, while only five percent of US-born adults with hypertension were uninsured.

“Ensuring that our immigrant community has access to quality and affordable care is crucial to the overall health and wellbeing of New York City,” said Health Commissioner Dr. Mary T. Bassett. “Many New Yorkers qualify for health insurance at no cost. If you think health insurance is out of reach, call 311 or text CoveredNYC to 877877 to find free help today.”

“New York City has made progress in making sure every resident has access to quality health care regardless of immigration status,” said Assembly Health Committee Chair Richard N. Gottfried.  “But this report shows there are still gaps in access for foreign-born New Yorkers.  With programs like ActionHealthNYC and the Center for Health Equity, we can help all New Yorkers get access to primary and preventive care and reduce health disparities.”

“"Thanks to ActionHealthNYC, which offers low-cost coordinated health care for all, we have successfully increased access to health insurance for the New York City immigrant community. This is a major milestone, but we must continue to work in order to ensure all New Yorkers have access to quality health care," said NYS Senator José M. Serrano 

“The Affordable Care Act has provided an opportunity for many immigrant New Yorkers to be able to seek health services and preventive care,” said Speaker Melissa Mark-Viverito. “Unfortunately for many, however, a person’s first interaction with a health facility is still the emergency room. The New York City Council is committed to making health care investments, like the Immigrant Health Initiative, so that foreign born adults seeking preventive care at local neighborhood clinics won’t be denied.”  

"It’s critically important that all New Yorkers, no matter if they are undocumented or not, have access to preventive and primary healthcare,' said Council Member Corey Johnson. “While there is still work to be done, I applaud the de Blasio administration for launching ActionHealthNYC to help close the gap of New Yorkers without health insurance. As Chair of the Committee on Health in City Council, I look forward to working with my colleagues at the Department of Health to expand healthcare coverage to our most vulnerable families."

"Our city has helped connect thousands of foreign-born residents with health insurance--but there is still work to be done," said NYC Council Member Daniel Dromm (D-Jackson Heights, Elmhurst).  "As a Council Member representing a district with one of the largest immigrant populations in the city, I join Commissioner Bassett in urging all New Yorkers without coverage to call 311 for information on low- to no-cost options that may be available to them."

Key Points

  • The premature mortality rate (death before age 65) was higher for U.S-born adults than foreign-born adults (293.0 vs. 149.3 per 100,000 adults, respectively) overall and across the five leading causes of death, with the exception of “accidents except poisoning” and “cancer.”
  • Three in 10 foreign-born Latinos were uninsured compared with 1 in 10 U.S.-born Latinos. Foreign-born Whites and foreign-born Blacks were twice as likely to be uninsured as their U.S.-born counterparts (12 percent vs. 6 percent, and 17 percent vs. 9 percent, respectively).
  • Regardless of insurance status, U.S.-born adults were more likely than foreign-born adults to have a primary care provider (89 percent vs. 79 percent).
  • While many chronic conditions were reported to be more common in U.S.-born adults than foreign adults, such as asthma, obesity and depression, being diagnosed with diabetes was more common in foreign-born adults than U.S.-born adults (12 percent vs. 9 percent).
  • A larger proportion of foreign-born adults with chronic health conditions reported being uninsured compared with U.S.-born adults with chronic health conditions: hypertension (19 percent vs. 5 percent), asthma (17 percent vs. 6 percent), obesity (25 percent vs. 8 percent), or having ever been told they have depression (16 percent vs. 7 percent).

If someone is uninsured, they can call 311 or text “CoveredNYC” (or “SeguroNYC,” for help in Spanish) to 877877 to find the closest free, in-person insurance enrollment assistor who can help explore health insurance coverage options.

New Yorkers can also visit and search “insurance” for information about where they can get health care services and medications at low or no cost.

To help address the problem faced by many New York City immigrants who cannot get insurance coverage because they are undocumented and ineligible for public health insurance and purchasing coverage in the Health Insurance Marketplace, the de Blasio administration launched enrollment for ActionHealthNYC in May 2016. ActionHealthNYC offers low-cost coordinated health care based upon income eligibility. In its initial year, ActionHealthNYC will enroll up to 1,200 individuals, which will allow the City to evaluate how best to expand the program for all families in NYC who do not have access to health insurance.

Any New Yorker who may be eligible for ActionHealthNYC should call 311 and say “ActionHealthNYC” to make an appointment. Enrollment ends August 13, 2016.

The Health Department has taken several important steps to address health inequities in NYC and connect New Yorkers to necessary testing and care. The agency has made progress in addressing health issues in every community, and promoting effective programs and initiatives, although many disparities remain. 

To address health disparities in NYC, the Health Department launched the Center for Health Equity in 2014. The Center addresses health disparities that result in an excess burden of ill health and premature mortality in New York City’s communities of color. The Center focuses on leveraging policy changes to better integrate primary care and public health, building interagency collaboration to address the root causes of health disparities, and increasing access to care by making services more accessible in areas with the worst health outcomes.

In 2015, the de Blasio administration unveiled One New York: The Plan for a Strong and Just City. One of its many goals is to ensure that all New Yorkers live a long and healthy life. The City is committed to reducing the premature mortality rate by 25 percent by 2040, so as to dramatically decrease disparities among racial/ethnic groups. 

In October of last year, the City launched Take Care New York 2020 – a comprehensive health blueprint that identifies key areas for health improvement across the city and for advancing health equity. TCNY 2020 includes an unprecedented community engagement approach, in which community members rank and prioritize health indicators for their neighborhood that they want to focus on and improve. These rankings are used to develop localized action plans that will be focused on health issues identified as top priority by residents during community consultations.

Earlier this year, during the State of the City address, Mayor de Blasio also announced the opening of new community health clinics under the Caring Neighborhoods plan – which will significantly expand primary care services in areas of the city with unmet healthcare needs – and the opening of three new Neighborhood Health Action Centers that will provide space for primary care and much-needed holistic non-clinical services in underutilized City-owned buildings located in communities with high rates of premature child and adult mortality.



Christopher Miller/Julien Martinez:
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