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As the first study to describe DACA-eligible young adults' health needs, these data demonstrate their profound mental health challenges and numerous barriers to health care access. Many barriers were attributed to their undocumented status and persisted even when they gained temporary legal status. This work provides a foundation for evidence-based policy changes to address the health needs of this and other undocumented populations.

Background:This paper provides statewide estimates on health care access and utilization patterns and physical and behavioral health by citizenship and documentation status among Latinos in California.Methods:This study used data from the 2011–2015 California Health Interview Survey to examine health care access and utilization and physical and behavioral health among a representative sample of all nonelderly Latino and US-born non-Latino white adults (N=51,386). Multivariable regressions estimated the associations between the dependent measures and citizenship/documentation status among Latinos (US-born, naturalized citizen, green card holder, and undocumented).Results:Adjusted results from multivariable analyses observed worse access and utilization patterns among immigrant Latinos compared with US-born Latinos, with undocumented immigrants using significantly less health care. Undocumented Latinos had lower odds of self-reporting excellent/very good health status compared with US-born Latinos, despite them having lower odds of having several physical and behavioral health outcomes (overweight/obesity, physician-diagnosed hypertension, asthma, self-reported psychological distress, and need for behavioral health services). Among those reporting a need for behavioral health services, access was also worse for undocumented Latinos when compared with US-born Latinos.Conclusions:Patterns of poor health care access and utilization and better physical and behavioral health are observed across the continuum of documentation status, with undocumented immigrants having the worst access and utilization patterns and less disease. Despite fewer reported diagnoses and better mental health, undocumented Latinos reported poorer health status than their US-born counterparts.

Although breast and cervical cancer screening rates for Asian American (AA) women are the lowest of any ethnic group in California, few causes for this are known. The authors used the 2001 California Health Interview Survey, conducted in five Asian languages, to conduct the first evaluation of Pap and mammography screening rates for a representative sample of 2,239 AA women. Wide variations in screening rates were found among the seven different subgroups of AA women studied: adjusted Pap test use ranged from 81% (Filipina Americans) to 61% (Vietnamese Americans). Mammography rates ranged from 78% (Japanese Americans) to 53% (Korean Americans). Disaggregating the AA data and using separate multivariate logistic regressions revealed that different factors were independently associated with the low screening rates for each subgroup. The measurement of additional contextual information is needed to identify structural barriers and community resources to provide clearer guidance for the design of effective screening promotion programs for AA subpopulations.

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The Medical Services Initiative program--a safety net-based system of care--in Orange County included assignment of uninsured, low-income residents to a patient-centered medical home. The medical home provided case management, a team-based approach for treating disease, and increased access to primary and specialty care among other elements of a patient-centered medical home. Providers were paid an enhanced fee and pay-for-performance incentives to ensure delivery of comprehensive treatment. Medical Services Initiative enrollees who were assigned to a medical home for longer time periods were less likely to have any emergency room (ER) visits or multiple ER visits. Switching medical homes three or more times was associated with enrollees being more likely to have any ER visits or multiple ER visits. The findings provide evidence that successful implementation of the patient-centered medical home model in a county-based safety net system is possible and can reduce unnecessary ER use.