Foreign-born Mexican Americans, particularly those who have lived in the United States for a short time, have more limited access to care than U.S.-born Mexican Americans, even after controlling for differences in the sociodemographic characteristics and insurance coverage between the two groups. However, for both native-born and immigrant Hispanics, the type of neighborhood in which they live plays an important role in their access to health care, according to a new study. José J. Escarce, M.D., Ph.D., of the University of California, Los Angeles, and colleagues studied patterns of health care use care among 8,371 Mexican Americans living in urban areas.
They found that for Mexican American immigrants, and in particular for recent immigrants, those living in predominantly Spanish-speaking areas have better access to health care services compared with immigrants living in other areas. For example, among insured immigrants, those living in an area with a relatively large Spanish-speaking population are more likely to fill a prescription, have a usual source of care, or visit a doctor's office compared with immigrants living in other areas. However, for U.S.-born Mexican Americans, living in an area that is predominantly Spanish speaking is not associated with better access to care and, in fact, for the uninsured, is associated with worse access to care. Uninsured native-born Mexican Americans in areas with a predominantly Spanish-speaking or foreign-born and Spanish-speaking population are less likely to visit a doctor's office or have any medical expenditures.
The authors suggest that immigrant Hispanics who live in areas more heavily populated by Spanish speakers or Spanish-speaking immigrants may form social networks that enable them to better navigate the U.S. health care system. These areas also are more likely to have local organizations dedicated to helping immigrants and physicians who are Hispanic or speak Spanish. Policymakers should be aware of how a lack of social networks may serve as a barrier for immigrants in accessing health care, the authors suggest. Their study, which used 1996 to 2002 Medical Expenditure Panel Survey data from the Agency for Healthcare Research and Quality (AHRQ), was funded in part by AHRQ (HS10770).
See "Community demographics and access to health care among U.S. Hispanics," by Carole Roan Gresenz, Ph.D., Jeannette Rogowski, Ph.D., and Dr. Escarce in the October 2009 Health Services Research 44(5), pp. 1542-1562.