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PUBLIC HEALTH

Latino Disparities in Prescription Drug Use and Expenditures: A Nationally Representative Analysis

Assistant Professor, Department of Political Science, Economics, and Philosophy, College of Staten Island/City University of New York, Staten Island, NY

Hai Fang, PhD MPH

Assistant Professor, Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado, Denver

Arturo Vargas-Bustamante, PhD

Assistant Professor, Department of Health Services, School of Public Health, University of California, Los Angeles

John A Rizzo, PhD

Professor, Department of Economics and Department of Preventive Medicine, Stony Brook University, Stony Brook, NY

Alexander N Ortega, MPH PhD

Professor, Department of Health Services, School of Public Health, University of California, Los Angeles

Reprints: Dr. Chen, Department of Political Science, Economics, and Philosophy, College of Staten Island/City University of New York, 2800 Victory Blvd., Room 2N-229, Staten Island, NY 10314, fax 718/982-2888, jiechen{at}mail.csi.cuny.edu

BACKGROUND: Latinos are disproportionately affected by the lack of affordable prescription drugs. Within the Latino population, there are significant heterogeneities in the patterns of prescription drug expenditures and use. However, studies have traditionally treated them as a single, monolithic group.

OBJECTIVES: To identify and quantify factors associated with disparities in drug use and expenditures between non-Latino whites and Latino subgroups.

METHODS: We examined trends in prescription drug use, total prescription drug expenditures, and the proportion of out-of-pocket (OOP) payment to total drug expenditures for whites and Latino subgroups using the Medical Expenditure Panel Survey from 1999 to 2006. Multivariate regressions were used to adjust for confounding factors that may also affect drug use and expenditures.

RESULTS: Latinos were significantly less likely to use drugs compared to whites. Mexicans had significantly lower prescription drug costs and a higher proportion of OOP expenditures compared to whites after socioeconomic and demographic factors were controlled. Usual source of care, health insurance, and limited English proficiency were the most important factors associated with these disparities. Among the Latino subgroups, Puerto Ricans had drug expenditures and use patterns most similar to those of whites.

CONCLUSIONS: Substantive disparities in prescription drug expenditures and use existed between whites and specific Latinos groups, with Mexicans faring the worst. Future health studies should examine Latino subgroups separately, rather than treating Latinos as a homogeneous group. Policies aimed at expanding insurance coverage and access to a usual source of care, as well as addressing language barriers, should substantially reduce these disparities.

Key Words: disparities, drug cost, Hispanic Americans, Latinos

Published Online, December 22, 2010. www.theannals.com, DOI 10.1345/aph.1M467