First, even if medical care has only a limited role as a determinant of health, it is nonetheless a health enhancing resource that is socially patterned. Table 7 shows national data on healthcare access and utilization.160 There are large racial differences in insurance coverage. In the pre-retirement years, Hispanics and American Indians are much less likely than whites, blacks and Asians to have any health insurance. The reduced access of many racial minorities to educational and employment opportunities noted earlier leads them to be overrepresented in poor quality jobs that do not provide health insurance. Some persons who do not receive employer-based insurance are eligible for public (means-tested) insurance coverage. Table 7 also shows that blacks, Hispanics and American Indians under the age of 65, are more likely than whites and Asians to have public insurance only. Moreover, for all racial groups, there is a strong positive relationship between having insurance and income and an inverse association between income and public insurance. However, there are substantial racial variations in insurance coverage at every level of income.
