Health care utilization barriers among Mexican Americans: evidence from HHANES 1982-84.

Abstract

Data from the Hispanic

Latino child health: need for inclusion in the US national discourse

“…30 High rates of noncoverage are associated with the following 2 factors: parents working in economic sectors that lack employment-linked health benefits 19,24,28,31,32 and multiple and persistent barriers experienced by Latinos in accessing health care. 27,29,[33][34][35][36][37][38][39] More than one third (36%) of Medicaid-eligible Latino children are not enrolled, and only about 32% of eligible Latino children receive Medicaid benefits. 35,37,40,41 Among Latino children, lack of health insurance is strongly associated with greater use of emergency rooms as a source of primary care, 33,36,42 less likelihood of having a usual source of care, 29,34,37,43 and less contact with a physician in the previous year.…”

“…Parental factors, particularly education and literacy levels, play a direct role in Latino children's health access and outcomes. 39,47,52,61,96,98 Families, often not aware of services or fearful of providers, place Latino children at risk for less use of preventive screening services, more lost school days, and potential health problems in adulthood. 4,29,91,100 Providers' involvement with parents may significantly increase the use of preventive and primary care services.…”

“…Such studies often cite data derived from the Hispanic Health and Nutrition Examination Survey 39,50,113,[122][123][124][125][126] or the third National Health and Nutrition Examination Survey, which included only Mexican Americans. 55,56,127,128 A recent review of Latino child health revealed that major research gaps include lack of subgroup data on parental and child health behaviors, chronic childhood illnesses, intentional and unintentional injuries, environmental health, migrant and US-Mexico border resident health, and mental health.…”

“…101 Measurement of a broader array of factors, such as community context, parental and child health behaviors, and other lifestyle factors, is important for understanding the links between poverty and adverse health outcomes. 16,17,39,[76][77][78][79][80]96,101,117 Broadening the scientific paradigm for understanding Latino child health involves examining the links among family, community, and cultural protective factors and institutional factors. 49,56,77,80,84,101,117 Although data limitations and research gaps have impeded the strategic process of including the needs of Latino children in the national health discourse, sufficient evidence now exists to inform priority policy recommendations.…”

“…The most pressing policy area for Latino families and children is lack of access to health care. 15,24,25,27,29,[32][33][34][35][36][37]39 Expanding access to health care services for Latino children and their families requires raising eligibility cutoffs to 250% of the poverty level for Medicaid, the State Child Health Insurance Program, and prenatal care programs for poor and working-class Latino families, especially those without employee-linked health benefits. Although many Latino families are eligible for such services, enrollment is low.…”