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Community Demographics and Access to Health Care among U.S. Hispanics
Author(s) -
Gresenz Carole Roan,
Rogowski Jeannette,
Escarce José J.
Publication year - 2009
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2009.00997.x
Subject(s) - immigration , american community survey , demography , medical expenditure panel survey , metropolitan area , population , health care , medicine , ethnic group , gerontology , socioeconomic status , probit model , health equity , geography , environmental health , public health , health insurance , census , nursing , sociology , political science , law , archaeology , pathology , machine learning , anthropology , computer science
Objective. To explore the influence of the communities in which Hispanics live on their access to health care. Data. 1996–2002 Medical Expenditure Panel Survey data, linked to secondary data sources and including 14,504 observations from 8,371 Mexican American respondents living in metropolitan areas. Study Design. We use multivariate probit regression models, stratified by individuals' insurance status, for analyses of four dependent variables measuring access to health care. We measure community characteristics at the zip code tabulation area level, and key independent variables of interest are the percentage of the population that speaks Spanish and percentage of the population that is immigrant Hispanic. Each of these measures is interacted with individual‐level measures of nativity and length of U.S. residency. Principal Findings. For Mexican American immigrants, living in an area populated by relatively more Spanish speakers or more Hispanic immigrants is associated with better access to care. The associations are generally stronger for more recent immigrants compared with those who are better established. Among U.S.‐born Mexican Americans who are uninsured, living in areas more heavily populated with Spanish‐speaking immigrants is negatively associated with access to care. Conclusions. The results suggest that characteristics of the local population, including language and nativity, play an important role in access to health care among U.S. Hispanics, and point to the need for further study, including analyses of other racial and ethnic groups, using different geographic constructs for describing the local population, and, to the extent possible, more specific exploration of the mechanisms through which these characteristics may influence access to care.