Article

Why Are Latinos the Most Uninsured Racial/Ethnic Group of US Children? A Community-Based Study of Risk Factors for and Consequences of Being an Uninsured Latino Child

Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
PEDIATRICS (Impact Factor: 5.3). 10/2006; 118(3):e730-40. DOI: 10.1542/peds.2005-2599
Source: PubMed

ABSTRACT Latinos continue to be the most uninsured racial/ethnic group of US children, but not enough is known about the risk factors for and consequences of not being insured in Latino children.
[corrected] The objective of this study was to identify the risk factors for and consequences of being uninsured in Latino children.
A cross-sectional survey was conducted of parents at urban, predominantly Latino community sites, including supermarkets, beauty salons, and laundromats. Parents were asked 76 questions on access and health insurance.
Interviews were conducted of 1100 parents, 900 of whom were Latino. Uninsured Latino children were significantly more likely than insured Latino children to be older (mean age: 9 vs 7 years) and poor (89% vs 72%) and to have parents who are limited in English proficiency (86% vs 65%), non-US citizens (87% vs 64%), and both employed (35% vs 27%). Uninsured Latinos were significantly less likely than their insured counterparts to have a regular physician (84% vs 99%) and significantly more likely not to be brought in for needed medical care because of expense, lack of insurance, difficulty making appointments, inconvenient office hours, and cultural issues. In multivariable analyses, parents who are undocumented or documented immigrants, both parents working, the child's age, and the $4000 to $9999 and $15000 to $19999 family income quintiles were the only factors that were significantly associated with a child's being uninsured; neither Latino ethnicity nor any other of 6 variables were associated with being uninsured. Compared with insured Latino children, uninsured Latino children had 23 times the odds of having no regular physician and were significantly more likely not to be brought in for needed medical care because of expense, lack of health insurance, difficulty making appointments, and cultural barriers.
After adjustment, parental noncitizenship, having 2 parents work, low family income, and older child age are associated with being an uninsured child, but Latino ethnicity is not. The higher prevalence of other risk factors seems to account for Latino children's high risk for being uninsured. Uninsured Latino children are significantly more likely than insured Latino children to have no regular physician and not to get needed medical care because of expense, lack of health insurance, difficulty making appointments, and cultural barriers. These findings indicate specific high-risk populations that might benefit most from targeted Medicaid and State Child Health Insurance Program outreach and enrollment efforts.

Download full-text

Full-text

Available from: Glenn Flores, Jul 01, 2015
0 Followers
 · 
76 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This systematic review identified 77 studies to examine patterns and determinants of health care access among Hispanic immigrants (HI) living in the U.S. In spite of major mental and physical care needs, HI and their families are at very high risk of not having access to health care compared with non-immigrant Hispanics and non-Hispanic whites. Noncitizenship status is a major barrier for accessing health care due to program ineligibility and fear of stigma and deportation. Low English proficiency is also an important barrier to health care. Culturally appropriate community outreach programs relying heavily on community health workers, also known as promotoras, have improved health care access and quality. Mexico shares the health care cost for HIs living in bordering states, calling for a binational dialogue. Mixed-methods research is needed to better understand: a) the net influence of acculturation on migrant health; b) the role of informal (e.g., family) vs. formal (e.g. promotoras) social support at facilitating health care access; c) issues related to 'single' male migrant farm workers; d) the "Hispanic mortality paradox"; e) traditional healing and medicine among HI. Comprehensive health and immigration reforms are needed to respect the human right that HIs have to gain access to health care.
    National Association for the Practice of Anthropology Bulletin 11/2010; 34(1):47-67. DOI:10.1111/j.1556-4797.2010.01051.x
  • Source
  • [Show abstract] [Hide abstract]
    ABSTRACT: An increasing vitriolic anti-immigrant discourse has grown in media venues in the last several years, creating a climate of fear and hatred of immigrants that has spawned violence against some of them at individual and systemic levels. Historically, metaphors have been used to create a public acceptance of policies of discrimination, racism, and even genocide of targeted social groups, including immigrants. This article examines the use of such metaphors, juxtaposing an analysis of nursing journal articles regarding immigrant health, and of major nursing organizations for policy statements that might support immigrant healthcare.
    ANS. Advances in nursing science 33(2):126-42. DOI:10.1097/ANS.0b013e3181dbc624 · 0.87 Impact Factor