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Determinants of access to and utilization of health services among undocumented Mexican immigrants in a US urban metropolitan area

Arijit Nandi, MPH1, Sandro Galea, MD, DrPH2, Gerald Lopez, JD3, Vijay Nandi, MPH4, and Stacey Strongarone, JD3. (1) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Department of Epidemiology, Baltimore, MD 21205, 917-553-3577, anandi@jhsph.edu, (2) Department of Epidemiology, University of Michigan School of Public Health, 1214 South University, Room 243, Ann Arbor, MI 48104, (3) Center for Community Problem Solving, New York University School of Law, 245 Sullivan Street, #630, New York, NY 10012, (4) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029

The access to and utilization of health services by undocumented immigrants in the United States (US) remains poorly characterized. We used data from a cross-sectional survey conducted in 2004 to assess the access and utilization of health services in a sample of adult Mexican-born immigrants living in New York City. The sample was recruited using venue-based sampling, with venues identified by key informants. Among the 431 undocumented Mexican immigrants sampled, the median year of entry into the US was 1999. 10.54% of immigrants reported health insurance coverage; in multivariable models, those who reported that poor health limited their activities for greater than 5 of the past 30 days [OR=3.40(95%CI=1.14-10.12); compared to 0 days] and those who earned more legal income in the past year [OR=4.75(95%CI=1.38-16.35); $10,000-20,000 vs. no legal income] were more likely to have access to health insurance. 36.47% of the sample reported having a regular health care provider. In multivariable models, females [OR=2.68(95%CI=1.50-4.76)], those with health insurance [OR=2.97(95%CI=1.35-6.50); vs. those without], those who were in the US before 1996 [OR=1.95(95%CI=1.15-3.30); vs. after 1996], and those with high levels of social support [OR=1.77(95%CI=0.95-3.31); vs. low levels] were more likely to have a regular health care provider; those reporting discrimination with respect to language [OR=0.55(95%CI=0.29-1.05); vs. those never discriminated against] were less likely to have a regular provider. Financial, personal, and cultural barriers restrict access to care among undocumented immigrants. Policies that address these barriers to care may benefit the health of this growing population.

Learning Objectives: At the conclusion of this session, the participant will be able to

Keywords: Access to Health Care, Immigrants

Presenting author's disclosure statement:

Not Answered

Commonalities and Differences in the Experiences of Diverse Immigrant Populations in the US, including those from Asia, Africa, Latin America and Eastern Europe

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA