Abstract
Immigrants are ineligible for federally-funded Medicaid in the U.S. until at least 5 years after arrival. There is little information on where they receive care in light of this restriction. Using Blinder–Oaxaca decomposition, this study examines whether the setting in which older recent immigrants receive care (i.e., health clinic, emergency room or doctor’s office) explains delays in care. Among older adults with a usual source of care, 13.5% of recent immigrants had not seen a health professional in the past year compared to 8.6% of non-recent immigrants and 6.3% of native-born. Approximately 23% of these differences is attributable to recent immigrants’ tendency to receive care in clinics and community health centers. Even when older recent immigrants manage to find a usual source of care, it is of lower quality than that received by their non-recent immigrant and native-born counterparts.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Carr S, Tienda M. Family sponsorship and late-age immigration in aging America: revised and expanded estimates of chained migration. Popul Res Policy Rev. 2013;32(6):825–49.
Fortuny K, Chaudry A. A comprehensive review Of immigrant access to health and human services. The Urban Institute. 2011. https://aspe.hhs.gov/basic-report/comprehensive-review-immigrant-access-health-and-human-services.
O’neil K, Tienda M. Age at immigration and the incomes of older immigrants, 1994-2010. J Gerontol B. 2014;70(2):291–302.
Nam Y. Welfare reform and elderly immigrants’ health insurance coverage: the roles of federal and state medicaid eligibility rules. J Gerontol Soc Work. 2011;54(8):819–36.
DeVoe JE, Tillotson CJ, Lesko SE, Wallace LS, Angier H. The case for synergy between a usual source of care and health insurance coverage. J Gen Intern Med. 2011;26(9):1059–66.
Forrest CB, Whelan E-M. Primary care safety-net delivery sites in The United States: a comparison of community health centers, hospital outpatient departments and physicians’ Offices. JAMA. 2000;284(16):2077–83.
Rosenblatt RA, Andrilla CHA, Curtin T, Hart LG. Shortages of medical personnel at community health centers: implications for planned expansion. JAMA. 2006;295(9):1042–9.
Taylor TB. Threats to the health care safety net. Acad Emerg Med. 2001;8(11):1080–7.
Mehrotra A, Liu H, Adams JL, Wang MC, Lave JR, Thygeson NM, et al. Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. Ann Intern Med. 2009;151(5):321–8.
Gidengil CA, Mehrotra A, Beach S, Setodji C, Hunter G, Linder JA. What drives variation in antibiotic prescribing for acute respiratory infections?. J Gen Intern Med. 2016:1–7.
DeVoe JE, Fryer GE, Phillips R, Green L. Receipt of preventive care among adults: insurance status and usual source of care. Am J Public Health. 2003;93(5):786–91.
Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995;36(1):1–10.
Centers For Disease Control And Prevention. Age-adjusted rates of diagnosed diabetes per 100 civilian non-institutionalized population, by race and sex, United States, 1980–2014. Atlanta: Author; 2015.
Centers for Disease Control and Prevention. Heart disease facts. Author. 2014. http://www.cdc.gov/heartdisease/facts.htm.
National Center for Health Statistics. Health, United States, 2015: with special feature on racial and ethnic disparities. 2016. http://www.cdc.gov/nchs/data/hus/hus15.pdf-022.
Choi S. Insurance status and health service utilization among newly-arrived older immigrants. J Immigr Minor Health. 2006;8(2):149–61.
Parsons VL, Moriarty C, Jonas K, Moore TF, Davis KE, Tompkins L. Design and estimation for the National Health Interview Survey, 2006-2015. National Center For Health Statistics. 2014. http://www.cdc.gov/nchs/data/series/sr_02/sr02_165.pdf.
Ponce NA, Hays RD, Cunningham WE. Linguistic disparities in health care access and health status among older adults. J Gen Intern Med. 2006;21(7):786–91.
Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. 2011. https://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Franklin S, Pio JR, Wong ND, Larson MG, Leip EP, Vasan RS, et al. Predictors of new-onset diastolic and systolic hypertension: the Framingham Heart Study. Circulation. 2005;111:1121–7.
Ries LAG, Harkins D, Krapcho M, Mariotto A, Miller B, Feuer E, et al. SEER cancer statistics review: Table I-11 Median Age Of Cancer Patients At Diagnosis, 2000-2003. National Cancer Institute. 2006. http://seer.cancer.gov/archive/csr/1975_2003/results_single/sect_01_table.11_2pgs.pdf.
Campos Horta M, Tienda M. Of work and the welfare state: labor market activity of mexican origin seniors. In: Vega WA, Markides K, Angel JL, Torres-Gil FM, eds. Challenges of Latino aging in the Americas. New York: Springer Science; 2015. pp. 49–76.
U.S. Department of Health And Human Services. Healthy people 2020: topics and objectives, older adults. Author. 2014. https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults/objectives.
Munnell AH. What is the average retirement age? Center for Retirement Research at Boston College. 2011. http://crr.bc.edu/wp-content/uploads/2011/08/ib_11-11-508.pdf.
Katz S, Akpom C. 12. Index of ADL. Med Care. 1976;14(5):116–8.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.
U.S. Department of Health and Human Services. 2013 National Health Interview Survey (NHIS) public use dataset: survey description. U.S. Department of Health and Human Services. 2014. ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2013/srvydesc.pdf.
Rao JNK, Scott AJ. On chi-squared tests for multiway contingency tables with cell proportions estimated from survey data. Ann Stat. 1984;12(1):46–60.
Šidák Z. Rectangular confidence regions for the means of multivariate normal distributions. J Am Stat Assoc. 1967;62(318):626–33.
Fairlie RW. an extension of the blinder-oaxaca decomposition technique to logit and probit models. J Econ Soc Meas. 2005;30(4):305–16.
Passel JS. Unauthorized migrants: numbers and characteristics. Pew Hispanic Center. 2005. http://www.pewhispanic.org/files/reports/46.pdf.
Rosenbaum SJ, Shin P, Jones E, Tolbert J. Community health centers: opportunities and challenges of health reform. The Henry J. Kaiser Family Foundation. 2010. http://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1195&context=sphhs_policy_facpubs.
Wallace SP, Torres J, Sadeph-Nobari T, Pourat N, Brown ER. Undocumented immigrants and health care reform. UCLA Center for Health Policy Research. 2012. http://healthpolicy.ucla.edu/publications/documents/pdf/undocumentedreport-aug2013.pdf.
Funding
This study was funded by a pilot grant from the NewCourtland Center for Transitions and Health (no grant number) [to Alma Vega] and the National Institute on Aging (P01AG022481) [to Emma Aguila].
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical Approval
The Institutional Review Board at the authors’ home institution exempted this research from review.
Research Involving Human and Animal Participants
This article does not contain any studies with human participants performed by
any of the authors.
Electronic Supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Vega, A., Porteny, T. & Aguila, E. The Role of Clinics in Determining Older Recent Immigrants’ Use of Health Services. J Immigrant Minority Health 20, 1468–1475 (2018). https://doi.org/10.1007/s10903-018-0693-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10903-018-0693-x