This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder—Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.
Aday, L.A., & Andersen, R. ( 1974). A framework for the study of access to medical care. Health Services Research, 9, 208-220.
2.
Alegria, M., Canino, G., Rios, R., Vera, M., Calderon, J., Rusch, D., et al. (2002). Inequalities in use of specialty mental health services among Latinos, African Americans, and Non-Latino whites. Psychiatric Services, 53, 1547-1555.
3.
Andersen, R. ( 1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior , 36, 1-10.
4.
Arcia, E., Skinner, M., Bailey, D., & Correa, V. ( 2001). Models of acculturation and health behaviors among Latino immigrants to the U.S. Social Science & Medicine , 53, 41-53.
5.
Bartus, T. ( 2005). Estimation of marginal effects using Margeff. Stata Journal, 5, 309-329.
6.
Blinder, A.S. ( 1973). Wage discrimination: A reduced form and structural estimates . Journal of Human Resources, 8, 436-455.
7.
Brown, E.R., Ojeda, V.D., Wyn, R., & Levan, R. ( 2000). Racial and ethnic disparities in access to health insurance and health care (Report). Los Angeles: UCLA Center for Health Policy Research.
8.
Bryant, C.A. ( 1982). The impact of kin, friend and neighbor networks on infant feeding practices. Cuban, Puerto Rican, and Anglo families in Florida . Social Science & Medicine, 16, 1757-1765.
9.
Carlisle, D.M., Leake, B.D., Brook, R.H. & Shapiro, M.F. ( 1996). The effect of race and ethnicity on the use of selected health care procedures: A comparison of south central Los Angeles and the remainder of Los Angeles county. Journal of Health Care for the Poor and Underserved, 7, 308-322.
10.
Centers for Disease Control and Prevention. ( 2007). National healthcare disparities report. Rockville, MD: Agency for Healthcare Research and Quality .
11.
Collins, S.C., Hall, A., & Heuhaus, C. ( 1999). U.S. minority health: A chartbook. New York: Commonwealth Fund.
12.
Doescher, M.P., Saver, B.G., Franks, P., & Fiscella, K. ( 2000). Racial and ethnic disparities in perceptions of physician style and trust. Archives of Family Medicine, 9, 1156-1163.
13.
Doty, M.M., & Ives, B.L. ( 2002). Quality of health care for Hispanic populations: Findings from the Commonwealth Fund 2001 Health Care Quality Survey (Report) . New York: Commonwealth Fund .
14.
Fairlie R. ( 2005). An extension of the Blinder-Oaxaca decomposition technique to logit and probit models. Journal of Economic and Social Measurement, 30, 305-316.
15.
Fiscella, K., Franks, P., Doescher, M.P. & Saver, B.G. ( 2002). Disparities in health care by race, ethnicity, and language among the insured: Findings from a national sample. Medical Care, 40, 52-59.
16.
Freiman, M.P., & Cunningham, P.J. (1997). Use of health care for the treatment of mental problems among racial/ethnic subpopulations. Medical Care Research and Review, 54, 80-100.
17.
Gaskin, D.J., Briesacher, B.A., Limcangco, R., & Brigantti, L. ( 2006). Exploring racial and ethnic disparities in prescription drug spending and use among Medicare beneficiaries. American Journal of Geriatric Pharmacotherapy, 4, 96-111.
18.
Haas, J., Philips, K.A., Sonneborn, D., McCulloch, C.E., Baker, L.C., Kaplan, C.P., et al. (2004). Variation in access to health care for different racial/ethnic groups by the racial/ethnic composition of an individual’s county of residence. Medical Care, 42, 707-714.
19.
Hargraves, J.L., & Hadley, J. ( 2003). The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Services Research, 38, 809-829.
20.
Kleinman, A.K., Eisenber L., & Good, B. ( 2006). Culture, illness and care: Clinical lessons from anthropologic and cross-cultural research. Focus, 4, 140-149.
21.
Lauderdale, D.S., Wen, M., Jacobs, E.A., & Kandula, N.R. ( 2006). Immigrant perception of discrimination in health care: The California Health Interview Survey 2003. Medical Care , 44, 914-920.
22.
Lillie-Blanton, M., & Hoffman, C. ( 2005). The role of health insurance coverage in reducing racial/ethnic disparities in health care. Health Affairs, 24, 398-408.
23.
Martin, L.M., Calle, E.E., Wingo, P.A., & Heath, C.W. ( 1996). Comparison of mammography and pap test use from the 1987 and 1992 national health interview surveys: Are we closing the gaps ? American Journal of Preventive Medicine, 12, 82-90.
24.
Monheit, A.C., & Vistnes, J.P. ( 2000). Race/ethnicity and health insurance status: 1987 and 1996. Medical Care Research and Review, 57, 11-35.
25.
National Center for Health Statistics. (2008 ). National Health Interview Survey (NHIS: Public-use data file and documentation). Retrieved May 14, 2009, from http://www.cdc.gov/nchs/nhis.htm
26.
Oaxaca, R.L. ( 1973). Male-female wage differentials in urban labor markets . International Economic Review, 14, 693-709.
27.
Ortega, A.N., Fang, H., Perez, V.H., Rizzo, J.A., Carter-Pokras, O., Wallace, S., et al. (2007). Health care access, use of services and experiences among undocumented Mexicans and other Latinos. Archives of Internal Medicine, 167, 2354-2359.
28.
Pérez, V.H., Fang, H., Inkelas, M., Kuo, A.A., & Ortega, A. ( 2009). Access to and utilization of health care by subgroups of Latino children. Medical Care, 47, 1-5.
29.
Pérez, D.J., Fortuna, L., & Alegria, M. ( 2008). Prevalence and correlates of everyday discrimination among U.S. Latinos. Journal of Community Psychology, 36, 421-433.
30.
Portes, A. ( 1998). Social capital: Its origins and applications in modern sociology. Annual Review of Sociology, 24, 1-24.
31.
Shi, L. ( 1999). Experience of primary care by racial and ethnic groups in the United States. Medical Care, 37, 2068-2077.
32.
Smedley, B. D., Stith, A. Y. & Nelson, A. R. (Eds). (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: Institute of Medicine of the National Academies.
33.
Stanley, T.D., & Jarrell, S.B. ( 1998). Gender wage discrimination bias? A meta-regression analysis . Journal of Human Resources, 33, 947-973.
34.
Todd, K.H., Samaroo, N., & Hoffman, J.R. ( 1993). Ethnicity as a risk factor for inadequate emergency department analgesia. Journal of American Medical Association , 269, 1537-1539.
35.
Waidmann, T.A., & Rajan, S. ( 2000). Race and ethnic disparities in health care access and utilization: An examination of state variation. Medical Care Research and Review, 57, 55-84.
36.
Weinick, R.M., Jacobs, E.A., Stone, L.C., Ortega, A.N., & Burstin, H. ( 2004). Hispanic health care disparities: Challenging the myth of a monolithic Hispanic population. Medical Care , 42, 313-320.
37.
Weinick, R.M., Zuvekas, S.H., & Cohen, J.W. ( 2000). Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Medical Care Research and Review, 55, 55-84.
38.
Zuvekas, S.H., & Taliaferro, G.S. (2003). Pathways to access: Health insurance, the health care delivery system, and racial/ethnic disparities, 1996-1999. Health Affairs, 22, 139-153.
