Immigrants and the Use of Preventive Care in the United States

ArticleinHealth Economics 18(7):783-806 · July 2009with13 Reads
DOI: 10.1002/hec.1401 · Source: PubMed
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.
    • "Several studies have reported that non-urgent health-related issues (such as prevention and chronic disease control) were disregarded relative to those issues considered essential (i.e., security, food, residence, and employment). Hence, immigrants frequently present poor disease control, are under-medicated, and are self-excluded from any preventive programs [28, 29]. The latter may be mainly attributed to accessibility barriers [30]. "
    [Show abstract] [Hide abstract] ABSTRACT: Immigrant mortality studies reveal conflicting results that were attributed to diversity in immigrant definition, different classifications, and lack of appropriate comparisons. This work studied mortality patterns of the immigrations absorbed in Israel. Short-term mortality was evaluated by comparing the Standardized Mortality Rate (SMR) of the first year after immigration to the SMR of the second to fifth years. Long-term mortality was evaluated by comparing recent immigrant cohorts to cohorts of immigrants who have been residents 5 and 10 years. Stratification was made by source country classification and gender. Data were derived from the Israel National Population Registry and were analyzed anonymously. Immigrants from developed and developing countries had the highest SMR in the first year, which considerably decreased in both short and long term. Immigrants from mid-developed countries had stable SMR in the short term followed by only a modest decrease in the long term. Ethiopian immigrants exhibited exceptionally low SMR in the first year, following which it increased but remained relatively low. Mortality patterns of different immigrant groups differ even under similar definitions, conditions, and period. Only immigrants of developed and developing countries presented the expected pattern of excessive short-term mortality, which consistently decreased with time. Unique mortality patterns were discovered among two groups: Immigrants from mid-developed countries presented stable mortality attributable to isolation and delayed adaptation, and Ethiopian low mortality attributable to pre-migration natural selection.
    Full-text · Article · Jun 2013
    • "Foreign-born residents constitute a growing proportion of the total population of the US. Evidence suggests that immigrants are often uninsured10111213 and tend to experience various barriers to health care utilization, particularly for preventive care and screening services [12, 14, 15]. Ku and Matani [11] found that noncitizens and their children are much more likely to be uninsured, which greatly reduces their ability to obtain care. "
    [Show abstract] [Hide abstract] ABSTRACT: Despite efforts to eliminate inequality in health and health care, disparities in health care access and utilization persist in the United States. The purpose of this study was to compare the access to care and use of health care services of US-born and foreign-born Asian Americans. We used aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005, including 2,500 participants who identified themselves as Asian. Associations between country of birth and reported access and utilization of care in the previous 12 months were examined. After controlling for covariates, being foreign-born was negatively related to indicators of access to care, including health insurance (OR = 0.29, 95%CI = 0.18-0.48), routine care access (OR = 0.52, 95%CI = 0.36-0.75), and sick care access [OR = 0.67, 95%CI = 0.47-0.96)]. Being foreign-born was also negatively related to all indicators of health care utilization (office visit: OR = 0.58, 95%CI = 0.41-0.81; seen/talked to a general doctor: OR = 0.69, 95%CI = 0.52-0.90; seen/talked to a specialist: OR = 0.42, 95%CI = 0.28-0.63) but ER visit (OR = 0.84, 95%CI = 0.59-1.20). There are substantial differences by country of birth in health care access and utilization among Asian Americans. Our findings emphasize the need for developing culturally sensitive health services and intervention programs for Asian communities.
    Full-text · Article · Oct 2011
    • "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.
    Full-text · Article · Jun 2009
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