Using data from the Medical Expenditure Panel Survey, we compare immigrants' use of preventive care with that of natives. We employ a multinomial switching regression framework that accounts for non-random selection into continuous private insurance, temporary private insurance, public insurance, and no insurance. Our results indicate that among the populations with continuous private coverage and without coverage (uninsured), immigrants, especially non-citizens, are less likely to use preventive care than natives. We find that the longer immigrants stay in the US the more their use of care approximates to that of natives. However, for most types of care, immigrants' use of care never fully converges to that of natives. Among the publicly insured population, immigrants' use of care is similar to natives, but non-citizen immigrants are significantly less likely to use preventive measures. We find that the ability to speak English does not have a significant effect on the use of preventive care among publicly insured persons.
"Migration also influences broader aspects of the ‘health of the public,’ including the background burden of chronic or latent diseases (both infectious and noninfectious) and patterns of preexisting immunity; it also influences the use and uptake of disease prevention and health promotion interventions, and health-care service utilization in general.22, 23 Ensuring that necessary information is both available and understood by diverse communities is an increasingly important aspect of public health planning and preparedness24–26 in nations with large mobile populations. This was recently shown by responses to the threat of influenza A/H1N1 importation, which included quarantine, isolation, or preventive interventions.27–29 "
[Show abstract][Hide abstract] ABSTRACT: International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced by global health events.
Emerging Health Threats Journal 06/2009; 2:e10. DOI:10.3134/ehtj.09.010
"Vijverberg (1993) reviews their applications in labor economics, which estimate earning differentials by union/nonunion status, public/private sector, occupational status, migrant/stayer distinction, formal/informal sector, and level of education and in housing demand by renter/owner status and household credit by demand/supply constraint. Important applications in food and health include investigation of shopping frequencies and food intake decisions (Wilde and Ranney 2000), effect of food label use on nutrient intakes (Kim, Nayga, and Capps 2000), comparison of body weights between individuals in the United States and Canada (Auld and Powell 2006), and use of preventive care among the immigrant population (Pylypchuk and Hudson 2008). All existing SRM applications feature regression functions for two sample regimes, governed by a binary probit equation (Amemiya 1985, pp. "
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES; To investigate the effects of lifestyles, demographics, and dietary behavior on overweight and obesity.
Continuing Survey of Food Intakes by Individuals 1994-1996, U.S. Department of Agriculture.
We developed a three-regime switching regression model to examine the effects of lifestyle, dietary behavior, and sociodemographic factors on body mass index (BMI) by weight category and accommodating endogeneity of exercise and food intake to avoid simultaneous equation bias. Marginal effects are calculated to assess the impacts of explanatory variables on the probabilities of weight categories and BMI levels.
Weight categories and exercise are found to be endogenous. Lifestyle, dietary behavior, social status, and other sociodemographic factors affect BMI differently across weight categories. Education, employment, and income have strong impacts on the likelihood of overweight and obesity. Exercise reduces the probabilities of being overweight and obese and the level of BMI among overweight individuals.
Health education programs can be targeted at individuals susceptible to overweight and obesity. Social status variables, along with genetic and geographic factors, such as region, urbanization, age, and race, can be used to pinpoint these individuals.
Health Services Research 05/2009; 44(4):1345-69. DOI:10.1111/j.1475-6773.2009.00969.x · 2.78 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Some immigrants and refugees might be more vulnerable than other groups to pandemic influenza because of preexisting health and social disparities, migration history, and living conditions in the United States. Vulnerable populations and their service providers need information to overcome limited resources, inaccessible health services, limited English proficiency and foreign language barriers, cross-cultural misunderstanding, and inexperience applying recommended guidelines. To increase the utility of guidelines, we searched the literature, synthesized relevant findings, and examined their implications for vulnerable populations and stakeholders. Here we summarize advice from an expert panel of public health scientists and service program managers who attended a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008, in Atlanta, Georgia.
American Journal of Public Health 06/2009; 99 Suppl 2(S2):S278-86. DOI:10.2105/AJPH.2008.154054 · 4.55 Impact Factor
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