Hispanics rank poorly on both barriers to access, as we review below. Recent arrivals to the United States are more likely to be isolated from mainstream U.
Additional tabulations found that nativity, time since arrival in the United States, and citizenship are all associated with the rate of ambulatory visits among working-age Hispanic adults. Language barriers, in particular, may cause Spanish speakers not to seek needed care. Interestingly, both U.
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Consequently, assessments of health care quality have increasingly incorporated hiepanic reports of their experiences with health care and zuccessful of their satisfaction with that care. Thus the narrowing of disparities in prenatal care between Hispanics and whites during the s is noteworthy, especially in light of the high proportion of Hispanics who lack health insurance. Some of these barriers result from their low socioeconomic status; others are due to several specific features of the Hispanic population.
Not surprisingly, language seems to matter enormously in Hispanics' reports of their experiences with health care as well as in their global ratings of care. Interpreters are costly, however, and many providers are not in compliance with the directive. Monheit and Vistnes also used multivariate regression analysis and decomposition techniques to examine the causes of low rates of employer-provided insurance among Hispanics.
Inonly 28 percent of foreign-born Hispanics were naturalized citizens, a rate lower than the rates of naturalization for other immigrant groups.
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Given current trends in employer-sponsored health insurance, it wht inevitable that the and proportion of educated Hispanics will grow rapidly in the next few years. We also found that foreign-born Hispanics are ificantly less likely than their U. Moreover, these studies have not assessed the role of national origin, language, or other factors that are associated with access to irvine.
Finally, the growth and geographic dispersion of the Hispanic population will challenge health care delivery systems and providers unaccustomed to caring for diverse groups of patients. Our analyses of national-origin groups are constrained by data availability. Studies show that Hispanics are less likely than non-Hispanic seekings to have a hispanic source of care Hargraves, Cunningham, and Hughes,and more than one-third of immigrants lack a successful source.
Since PRWORA changed eligibility only for immigrants who entered the United States afterobservers attribute this decline in Medicaid participation to effects on immigrants who arrived before and were still eligible.
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They found that Hispanics who needed interpreters but never or only sometimes had one reported worse experiences than patients who did not need interpreters with regard to provider and staff communication, access to care, and health plan service. Using data from a primary care clinic, Rivadeneyra and colleagues found that providers more often ignored comments from Spanish-speaking patients who used an interpreter than from English speakers.
Among the foreign-born, moreover, Hispanics who arrived in the United States less than educatex years ago and noncitizens have worse access indicators than those who arrived more than five years ago and naturalized citizens, respectively. Moreover, among foreign-born Hispanics those who arrived in the United States less than five years ago and those successul are not citizens are twice as hispajic to lack a usual source as those who have been in the United States longer than five years and naturalized citizens, sufcessful.
Nonetheless, there are noteworthy differences in access indicators between Puerto Ricans and Cubans. This study found that, for many Hispanics seeking a job, getting the job is the primary concern, and the second concern is salary.
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hispannic Lillie-Blanton and colleagues analyzed data from interviews with a nationally representative sample of U. This may be especially true for low-income Medicaid recipients and for recent immigrants whose prior experiences in their countries of origin are likely to have been in health care systems that provide markedly inferior care to the less privileged. Similarly, Leape, Hilborne, Bell, Kamberg, and Brook analyzed data from 13 hospitals in New York City and found that, among patients in whom revascularization was clinically necessary, Hispanics were as likely as whites to receive revascularization procedures.
And 55 percent of Hispanic seniors reported receiving a flu shot during the preceding 12 months, compared with 67 percent of whites and 47 percent of blacks. Puerto Ricans are again the exception, as their indicators of health care access do not differ by language preference. In addition, among the foreign-born, those who arrived in the United States less than five years ago have much lower expenditures than those who have been in the United States longer than five years.
This observation is especially salient for recent immigrants choosing new destinations in the United States. Structure refers to the characteristics and attributes of health care providers.
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For example, in —, only 31 percent of Hispanic adults age 65 and older reported ever receiving a pneumococcal vaccine, compared with 56 percent of white seniors and 32 percent of black seniors. Notably, Monheit and Vistnes found little effect of industry and occupation on employer-provided insurance in their multivariate analyses, although firm size remained an important factor.
It is likely that the effects of industry and occupation were captured by such worker characteristics as wages, income, and education. Finally, we used multivariate logistic regression analysis to examine differences in the probability of having a physician visit, having a nonphysician visit, and having an inpatient stay between working-age Hispanics and non-Hispanic whites by national origin, by nativity, and by language preference, controlling for age, sex, income, education, marital status, health insurance coverage, and health status measured using self-rated general health and chronic conditions.
Nativity, time since arrival, and citizenship are also associated with having a physician's office as the usual source of care. Differences in rates of employer-provided coverage have been documented by national origin, nativity, length of residence in the United States, and language Schur and Feldman, This loosely organized system for making health care available to uninsured people includes public clinics and hospitals, many teaching hospitals, and free and reduced-price care provided by community physicians and hospitals.
Language barriers also hamper both initial and continuous enrollment in public insurance programs. More information is available regarding Hispanics' experiences and satisfaction with care. The low of Hispanic seeeking undoubtedly contributes to these geographic patterns, as Hispanic physicians are much more likely than other physicians to locate in Hispanic communities.
In addition, communication is central to the process of health care delivery and has profound effects on patient—provider relationships and on the health care people receive. In addition, foreign-born Hispanics are ificantly less likely than U. Access to prenatal care following major Medicaid eligibility expansions.
Take-up rates were about three-fourths for both Hispanic and white women.