Health Care Reform Debate

Survey shows disparities in health care coverage for Minnesota kids

by Tim Nelson, Minnesota Public Radio
September 22, 2009

St. Paul, Minn. — Minnesota ranks third in the nation in the percentage of people who have health insurance, according to recent figures from the U.S. Census. But new survey data indicate some disparities around the state - particularly for kids.

The Census Bureau's annual American Community Survey looked closely at health insurance coverage for the first time in 2008.

Overall, Minnesota fared well, ranking behind only Massachusetts and Hawaii in the percentage of its population covered by health insurance.

Figures released last week estimate about 8.7 percent of Minnesotans don't have health insurance, but that's not true everywhere.

New annual survey data released today by the Census show, for example, that nearly one in six people in Minneapolis lack health insurance coverage, nearly twice the state average.

St. Paul and Duluth fared slightly better, but the two cities are still closer to the national average of 16 percent uninsured than the state as a whole.

Duluth also stood out on another measure. The survey data indicate about one in eight kids in Duluth have no health insurance. It may be the only area in the state where adults appear to have measurably better coverage than children.

Across the rest of Minnesota, about one in sixteen kids may be without health coverage, according to the survey.

Jenny Peterson, program development director at Generations Health Care Initiative in Duluth, said her organization studies and advocates for health care access.

Peterson said kids in northeastern Minnesota have lagged the rest of the state for health care in other recent studies as well. She said lower incomes in the region, or low population density may be factors.

"I also think there are many times people are very proud and don't want to look to public assistance when they think they can do things on their own," Peterson said. "So we maybe have more of a culture like that in this area. I'm not sure."

Her program is trying to launch a school-based initiative to get more kids covered by public health plans.

On the other hand, the new survey numbers show some encouraging signs about health insurance.

The data show, for example, that the rate of insurance coverage is about the same for the Twin Cities and the rest of Minnesota. Suburban Washington County fared the best -- fewer than than five percent of residents there may not have health insurance.

The American Community Survey data also show about six in every seven Minnesotans with health insurance are covered by private plans, rather than public health insurance, higher than the rest of the county.

The survey says nationwide, only about five out of every six people have employer-sponsored plans or pay for their own health coverage.

State Demographer Tom Gillespy cautions that the information is only a survey. While released by the Census Bureau, it doesn't have the statistical quality of the ten-year count.

"You're giving up a lot of size of sample, which means that some of the numbers, you're not really sure whether they're really an increase or a decrease from the previous year, because the margin of error, or the sampling error is enough that there's always a certain amount of uncertainty," Gillespy said.

For example, the margin of error could be more than 50 percent for data covering areas as small as Duluth. That could account for the difference between uninsured kids and adults in Duluth, and also between kids in Duluth and in other parts of the state, although other surveys have had similar findings.

Groups such as the Children's Defense Fund of Minnesota, which tracks health coverage, say even county-level data may be too small to be a statistically definitive.

The health insurance survey data is also new this year, which means it doesn't have a long track record to corroborate the data. It also doesn't have detailed information on race, poverty and other factors. More complete data is expected to be released later this year.