Access to and Use of Health Services Among Undocumented Mexican Immigrants in a US Urban Area

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
American Journal of Public Health (Impact Factor: 4.55). 02/2008; 98(11):2011-20. DOI: 10.2105/AJPH.2006.096222
Source: PubMed


We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004.
We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care.
In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care.
Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population.

Full-text preview

Available from:
  • Source
    • "The failure of the US government to develop a comprehensive national solution to the problem of undocumented immigrants prompted state and local governments to act unilaterally in passing legislation to curb immigration by penalizing businesses who employ immigrants (Varsanyi 2008: 33–8; Gomberg-Munoz and Nussbaum-Barberena 2011: 66–75), prohibiting undocumented immigrants' access to public benefits and services (Kullgren 2003: 1630–3; Nandi et al. 2008: 2014–9) and mobilizing local police resources for the enforcement of federal immigration laws (Varsanyi 2008: 30–3; Khashu 2009: 2–5; Varsanyi 2011: 299–302). These measures generated so much fear and uncertainty that large numbers of undocumented immigrants are forced into an existence outside the protection of the law. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Policing anonymous and fearful undocumented migrant workers (UMWs) with equity, integrity, and accountability is one of the toughest law enforcement challenges in the United States. The importance of the issue notwithstanding, police-UMW interactions remain a ‘black box’ in police research. We examined the political economy of Palisades Park, New Jersey, and interviewed 160 UMWs from the same town. Findings indicate that UMWs suffered from a high level of crime victimization but were extremely unlikely to report their victimizations. Yet they were eager to contact the police to seek information and assistance in non-legal contexts. Police closely monitored UMWs through frequent encounters without provoking widespread resentment. Contradictions in both national immigration control and local politics are offered to interpret police-migrant relations.
    Full-text · Article · Jan 2016 · British Journal of Criminology
  • Source
    • "Immigrants have been found to suffer progressively worse health outcomes over time as they struggle with incorporation into U.S. society. Longterm poverty, the stress of incorporation into the dominant Anglo society, as well as racial discrimination have been argued to be contributing factors for adverse health outcomes (Nandi et al., 2008; Sullivan & Rehm, 2005). Latino immigrants face considerable disadvantages in obtaining health care services compared to native-born Latinos (Shobe, Coffman, & Dmochowski, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This article presents findings from a qualitative study of Latino immigrant experiences seeking health care services in the wake of an anti-immigrant “crackdown” ordinance similar to Arizona's SB 1070. Prince William County, Virginia's 2007 “Rule of Law” ordinance escalated law enforcement efforts that targeted this population for deportation and ordered staff to ensure that no one receive social services other than those required by federal law. This article sought to answer the questions: (1) Were undocumented immigrants able to obtain health care? (2) How do immigrants characterize their experiences with health providers? Data were gathered via semi-structured interviews (n = 57) with Latinos in a low-income neighborhood. Analysis of Spanish-language narratives found that many were dissuaded from seeking care because of high costs as well as lack of familiarity with the health care system. Others perceived that they were treated with insensitivity or outright hostility—and believed this treatment was a deliberate effort to discourage them from seeking help.
    Full-text · Article · Oct 2012 · Journal of Human Behavior in the Social Environment
  • Source
    • "Over the years, demographic and social factors have shown to contribute to people's decision to participate in health promotion programs (Sohler et al., 2009; Tedstone Doherty & Kartalova-O'Doherty, 2010). Migratory status has also proved to influence the use of health services (Kim et al., 2010; Kim, Jang, Chiriboga, Ma, & Schonfeld, 2010; Leduc, 1999; Leduc et al., 1999; Nandi et al., 2008). Nonetheless, there has been little attention to the individual motivation for enrollment in HIV prevention programs, except for a couple of meta-analyses (Durantini & Albarracin, 2009; Durantini et al., 2006; Noguchi et al., 2007), even when the government has been spending vast resources on that field. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although reducing HIV risk is a primary motive for the design of HIV prevention interventions, the goals of the clients may be very different. Social theories of gender suggest that women, who often seek to resolve social and relational problems, may see HIV-prevention counseling as a mean of resolving partner violence. In contrast, men, who often worry about their physical strength, may seek to enroll in HIV-prevention programs when they experience physical symptoms unrelated to HIV. An unobtrusive study was conducted to observe enrollment in HIV risk-reduction counseling after measuring partner-violence complaints (e.g., feeling threatened or being hit), emotional complaints (e.g., fatigue or anxiety), and physical complaints (e.g., cardiovascular or digestive symptoms). The sample was a group of 350 participants, 70% clients from a state-health department in North Central Florida and 30% community members. Consistent with predictions, complaints of partner violence had a positive association with enrollment in women but not in men, whereas complaints about physical health had a positive association with enrollment in men, but not in women. Emotional complaints did not predict enrollment in either gender group. This study suggests that broad, gender-specific population needs must be competently addressed within HIV-prevention programs and may be strategically used to increase program enrollment.
    Full-text · Article · Mar 2012 · AIDS Care
Show more