Many Hispanics Shut Out of U.S. Health Care System

Immigration status and health insurance play key roles in access to care, survey finds

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By
HealthDay Reporter

WEDNESDAY, Aug. 13, 2008 (HealthDay News) -- An estimated 25 percent of Hispanics in the United States don't have a regular health care provider to treat their medical needs.

And these people tend to be the newest documented and undocumented immigrants and those without health insurance, a new survey found.

The survey, conducted by the Pew Hispanic Center and the Robert Wood Johnson Foundation, is important because it paints a picture of health care among Hispanics in the United States, according to William Vega, a family medicine professor at the David Geffen School of Medicine at the University of California, Los Angeles.

Hispanics make up the largest minority group in the United States, comprising 45 million people and growing, Vega noted during a teleconference Tuesday.

"The gradient of time in the country and being born in the country or outside the country has a lot to do with how people perceive and experience the health care system, and especially the deficits of that system," Vega said.

One key finding of the survey was how many Hispanics lack a "medical home" -- a regular provider to supply medical care.

"If you compare these numbers to those from the U.S. Centers for Disease Control and Prevention, Latinos are more than twice as likely to lack a usual health care provider," Gretchen Livingston, a senior researcher at the Pew Hispanic Center, said during the teleconference.

And that could pose problems because rates of diabetes are high among Hispanics. But nearly one-third of the survey respondents said they know little about the disease or how to prevent or manage it.

Hispanic men are less likely to have a usual health care provider than women, 37 percent to 17 percent, respectively, Livingston noted. And younger Hispanics are less likely to have a usual provider than older ones. Education levels also play a role, with one-third of high school dropouts lacking a usual provider, compared with 19 percent who have some college, she said.

"We found a number of characteristics of health care access that are particular to Latinos," Livingston added. "Especially important is assimilation."

For instance, foreign-born Hispanics are less likely to have a usual health care provider, as are those who only speak Spanish, Livingston said. Among those who have been in the United States for five years or less, 49 percent don't have a regular care provider, compared with 21 percent of Hispanics who have been in the United States for 15 years or more, according to the survey.

Access to health insurance plays a big role, too, the survey found.

"Among people who have health insurance, 19 percent lacked a usual health care provider, compared to 42 percent of people who lack health insurance," Livingston said.

Curiously, many Hispanics who don't have a usual health care provider were born in the United States and are educated, and 45 percent have health insurance, Livingston said. "This suggests that it's not only financial reasons that are keeping Latinos from doctors," she added.

Among those who did seek regular care, more than 75 percent said their care was "good" or "excellent," Livingston said. Those with positive experiences typically had a usual health care provider and health insurance.

"Among those people who reported they were not satisfied with their health care, the most common reason why they received poor health care was financial," Livingston said. "They felt that their health care professional did not provide good care because they did not have the means to pay for the health care."

About 8 percent of Hispanics, mostly those who live near the Mexican border, said they crossed the border for their health care. This was particularly common among people who rated their U.S. health care as poor, Livingston said.

Another aspect of the survey dealt with how Hispanics get their medical information. "About a third of Hispanics get their medical information from doctors," Susan Minushkin, deputy director at the Pew Hispanic Center, said during the teleconference.

Women, older Hispanic men, more educated Hispanics, those born in the United States, and those with insurance and a usual care provider are more likely to get their medical information from doctors, Minushkin said.

Many Hispanics get their health care information from Spanish television and radio, Minushkin said. Hispanics who are bilingual or English speakers and better educated and younger tend to get health information from the Internet, she added.

More information

For more on Hispanics and health care, visit the Pew Hispanic Center.

SOURCES: Aug. 12, 2008, teleconference with Gretchen Livingston, senior researcher, and Susan Minushkin, deputy director, Pew Hispanic Center, Washington, D.C.; William Vega, Ph.D., professor of family medicine, David Geffen School of Medicine, UCLA; Aug. 13, 2008, Pew Hispanic Center/Robert Wood Johnson Foundation survey

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