Being foreign-born affects access to care
Research Activities, February 2012, No. 378
A new study of factors influencing access to health care finds that being foreign-born or native-born (nativity) can have a significant effect on access to care in both Canada and the United States, independent of race/ethnicity or socioeconomic status. The researchers found disparities in access to care based on nativity status overall, as well as by nativity-by-race joint effects in both countries. Using data on more than 6,000 non-elderly adults from the Joint Canada-U.S. Survey of Health, the researchers found that foreign-born adults in the U.S. had 48 percent lower odds of having a consultation with a health professional in the past 12 months than did native-born adults, after accounting for potential confounding from other sociodemographic and health-related factors.
When the researchers looked at joint effects of nativity and race/ethnicity on access to care, they found even greater disparities. In the United States, foreign-born Hispanics had 55 percent lower odds of having a regular medical doctor than did native-born non-Hispanic whites. However, the difference in these odds between native-born Hispanics and native-born non-Hispanic whites was not significant. In addition, foreign-born whites had 58 percent lower odds than native-born whites of having a consultation with a health professional within the past 12 months. Yet, both foreign- and native-born Hispanics had 35 percent and 42 percent lower odds, respectively, of having had a dental visit in the past 12 months than native-born non-Hispanic whites.
Education level affected access to care in the United States more strongly among native-born than foreign-born adults. Specifically, higher education was associated with better access to consulations with a health professional and dental visits among the native-born, but this association was not found among the foreign-born. However, there were few nativity-by-income joint effects. The study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00029).
More details are in "Nativity status and access to care in Canada and the U.S.: Factoring in the roles of race/ethnicity and socioeconomic status," by Lydie A. LeBrun, Ph.D., M.P.H., and Leiyyu Shi, Dr.P.H., M.B.A., M.P.A. in the August 2011 Journal of Health Care for the Poor and Underserved 22(3), pp. 1075-1100.