When The Color Line Meets The Borderline: Health Insurance Coverage Among Black Immigrant Adults In The US

Black immigrants represent a growing share of the immigrant population in the United States and may face unique barriers to health insurance coverage. Using microdata from the 2017-21 American Community Survey five-year estimates, supplemented by an imputation of documentation status, we compared Black immigrants with their US-born Black and US-born and immigrant White, Latino, and Asian American and Pacific Islander (AAPI) counterparts. We found that Black immigrants had higher uninsurance rates than almost every other group except non-Black Latino immigrants. After covariates were controlled for in multivariable regression models, Black immigrants had 9 percent higher odds of being uninsured when compared with US-born White people. There were no significant differences in adjusted insurance rates between US-born White and Black people. Non-Black Latinos had notably high odds of being uninsured, with US-born Latinos experiencing a 31 percent higher likelihood of lacking coverage and Latino immigrants reporting more than double those odds. US-born people and AAPI immigrants reported significantly lower odds of being uninsured. We offer suggestions to community organizations and program planners to improve health insurance coverage among Black immigrants.