# Evaluating the roles of healthcare and community factors on healthcare disparities among aging immigrants

> **NIH NIH R21** · UNIVERSITY OF CHICAGO · 2024 · $413,660

## Abstract

PROJECT SUMMARY/ABSTRACT
Latinxs are aging faster than other racial/ethnic group in the US. By 2050, they are projected to
be the largest share of the immigrant, older population. As Latinx immigrants age, they
experience the fastest decline in health and emerging health disparities, despite having an initial
health advantage. Limited access to health insurance and delayed healthcare utilization is a
major determinant of health disparities in older age among Latinx immigrants. Research on how
health insurance and access shape health disparities among aging Latinxs is limited by (1)
confounding between insurance and immigration and socioeconomic characteristics that shape
health and (2) simultaneous changes in insurance access and lifecourse aging as Latinxs enter
older adulthood. To address these challenges, the objective of the proposed study is to leverage
a policy intervention in Illinois to study changes in health insurance and healthcare utilization
among Latinx older-adults using quasi-experimental methods. In 2020 and 2022, Illinois
launched the Health Benefits for Immigrant Seniors (HBIA) and Health Benefits for Immigrant
Adults (HBIA) programs which were the first state policies that extended coverage equivalent to
full-scope Medicaid to low-income undocumented immigrants and noncitizens ages 42 and
older. The proposed study will be the first empirical examination of the HBIA and HBIS programs
to study health insurance and healthcare changes among Latinx older adults that have
implications for health and aging. Our study aims are: (1) To study changes in (a) emergency
department (ED) utilization and hospitalizations among Latinx older adults and (b)
uncompensated hospital care, following implementation of HBIA/HBIS.; (2) To study how
patient-level social determinants of health (SDOH) shape changes in ED utilization and
hospitalizations following the implementation of HBIA/HBIS. We will use Illinois hospital
CompData, Medicare Costs data, and zip-code linked American Community Survey to examine
changes in outcomes from 2018-2023 using interrupted time series and difference-in-difference
analysis. This proposed research leverages a novel policy in a major immigrant state to
examine how health insurance shapes healthcare among foreign-born Latinx older adults. The
findings would contribute to scholarship on the drivers of health disparities among the growing
aging immigrant population, and policy policies to expand health insurance to undocumented
and noncitizens excluded from healthcare. Collectively these finds would illuminate processes
and policies that shape the health of immigrant Latinxs, a significant segment of the nation’s
growing older adult population.

## Key facts

- **NIH application ID:** 10979354
- **Project number:** 1R21AG089148-01
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** Aresha Maree Martinez-Cardoso
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $413,660
- **Award type:** 1
- **Project period:** 2024-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10979354

## Citation

> US National Institutes of Health, RePORTER application 10979354, Evaluating the roles of healthcare and community factors on healthcare disparities among aging immigrants (1R21AG089148-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10979354. Licensed CC0.

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