Immigrants and Health Care — At the Intersection of Two Broken Systems

Okie, Susan

doi:10.1056/nejmp078113

Cited by 105 publications

(73 citation statements)

References 3 publications

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“…However, what part undocumented immigrants, who only account for about 20% of the nation's uninsured population, play in this problem is not entirely clear (Okie, 2007). Undocumented immigrants who do not have the means to gain access to medical care, which is available by paying in cash or with public or private medical insurance, often find the door closed to most health care (Rodriguez, Ward, & Perez-Stable, 2005).…”

Section: Introductionmentioning

confidence: 99%

Undocumented immigrants and their use of medical services in Orange County, California

Chávez

2012

Social Science & Medicine

102

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a b s t r a c tDoes an undocumented immigration status predict the use of medical services? To explore this question, this paper examines medical care utilization of undocumented Latino immigrants compared to Latino legal immigrants and citizens, and non-Latino whites in Orange County, California. Data were collected through a random sample telephone survey of 805 Latinos and 396 non-Hispanic whites between January 4 and January 30, 2006. Findings show that undocumented immigrants had relatively low incomes and were less likely to have medical insurance; experience a number of stresses in their lives; and underutilize medical services when compared to legal immigrants and citizens. Predictors of use of medical services are found to include undocumented immigration status, medical insurance, education, and gender. Undocumented Latinos were found to use medical services less than legal immigrants and citizens, and to rely more on clinic-based care when they do seek medical services.

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Section: Introductionmentioning

confidence: 99%

Undocumented immigrants and their use of medical services in Orange County, California

Chávez

2012

Social Science & Medicine

102

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“…Some states and municipalities such as Illinois, New York, the District of Columbia and certain cities in California utilize their own funds to expand health insurance coverage, even for undocumented immigrants, children, and pregnant women with low incomes. Nevertheless, other states, such as Arizona, Colorado, Georgia, and Virginia, have approved laws which make it even more difficult for non-citizens to access health services (Okie, 2007). In states such as California and Texas which border Mexico, the impact of this legislation has generated distinct problems and solutions.…”

Section: Resultsmentioning

confidence: 99%

“…Beyond the discussions surrounding spending on health for the immigrant population, it is important to consider that they live, work and study in the US and, nevertheless, the laws and bureaucratic barriers which reduce their utilization of preventative health services such as immunizations and programs combating infectious disease contribute to bad public health policy, since by denying primary care to immigrants, these laws increase the cost of health care for everyone (Okie, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…The majority of employers do not offer health care and immigrants cannot pay the premiums for insurance and/or medical care, and furthermore, they face language and cultural barriers (Okie, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Based on the information obtained through research projects on the topic Immigration and Health in the USA (Footracer, 2009;Hoofer et al, 2008;Du Bard and Massing, 2007;Okie, 2007;Ku, 2009;Goldman et al, 2006;Mohanty et al, 2005), the association between the lack of health insurance and the undocumented resident's condition, low levels of education, higher poverty rates, lower disease mortality rates and employment which is less likely to provide health coverage leads to less access to health services and restricted utilization of these services by immigrants to the USA.…”

Section: Introductionmentioning

confidence: 99%

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O acesso aos serviços de saúde por emigrantes brasileiros nos Estados Unidos

2013

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A análise do atual contexto político e econômico existente nos EUA, que envolve o acesso e utilização de serviços de saúde pelos imigrantes, diz respeito aos mais de 20 milhões de indivíduos estrangeiros que residem naquele país e não possuem seguro de saúde. Essa população corresponde a 43,8% de 46 milhões de pessoas que não possuem cobertura de provedores privados de saúde nos EUA, sendo 10,5 milhões residentes sem a documentação exigida para viver no País. Para explorar as necessidades, o acesso e a utilização dos serviços de saúde americanos pelos emigrantes de Governador Valadares, MG, Brasil, o presente estudo entrevistou uma amostra de 14 emigrantes valadarenses selecionada por meio da técnica bola de neve. Foram elaboradas questões relacionadas à documentação, local de residência, profissões exercidas, necessidade, acesso e utilização de serviços de saúde. As informações recolhidas junto aos emigrantes residentes nos Estados de Massachusetts e Connecticut permitem afirmar a viabilidade do acesso e da utilização dos serviços de saúde subsidiados pelos governos federal e estaduais e de organizações não governamentais.

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Association between insurance status at diagnosis and overall survival in chronic myeloid leukemia: A population‐based study

Perry

Brunner

Zou

et al. 2017

Cancer

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Background Chronic myeloid leukemia (CML) can be treated effectively with tyrosine kinase inhibitor (TKI) therapy directed at BCR-ABL, but access to care, medication cost, and adherence may be barriers to treatment. We sought to determine whether insurance status at diagnosis influences CML patient outcomes. Methods We used the Surveillance, Epidemiology, and End Results Program (SEER) database and identified 5784 patients age 15 or older, diagnosed with CML between 2007 and 2012, with insurance status documented at diagnosis. Primary outcomes were 5-year overall survival. Covariates of interest included age at diagnosis, race, ethnicity, sex, county-level socioeconomic status, and marital status. Overall survival was evaluated by log-rank test and Kaplan-Meier estimates. Results Among patients age 15 to 64, insurance status was associated with overall survival (p<0.001), where being uninsured or having Medicaid was associated with worse 5-year OS compared to insured patients (uninsured 72.7%, Medicaid 73.1%, insured 86.6%). For patients over age 65, insurance had less of an impact on OS (p=0.07), with similar 5-year OS rates between patients with Medicaid and those with other insurance (40.2% vs. 43.4%). In multivariable analysis of patients age 15-64, both uninsured (HR 1.93, p<0.001) and Medicaid patients (HR 1.83, p<0.001) had an increased hazard of death compared to insured patients; age under 40, female sex, and married persons also had a lower hazard of death. Conclusion Our findings suggest that CML patients under age 65 who are uninsured or have Medicaid have significantly worse survival compared to patients with other insurance coverage.

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Immigrants and Health Care — At the Intersection of Two Broken Systems

Cited by 105 publications

References 3 publications

Undocumented immigrants and their use of medical services in Orange County, California

Undocumented immigrants and their use of medical services in Orange County, California

O acesso aos serviços de saúde por emigrantes brasileiros nos Estados Unidos

Association between insurance status at diagnosis and overall survival in chronic myeloid leukemia: A population‐based study

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