Medicaid enrollment and health services access by Latino children in inner-city Los Angeles.
OBJECTIVE
To understand the role of parental immigration status on Medicaid enrollment and access to health services for young Latino children.


METHODS
A cross-sectional household survey of the parents of inner-city Latino children.


METHODS
South Central and East Los Angeles, Calif, 1992.


METHODS
Children 12 to 36 months old and their parents from 817 Latino families.


METHODS
Continuous Medicaid enrollment, continuity of care, deferral of care, and number of visits.


METHODS
Univariate analysis, logistic and linear regression by demographic and socioeconomic characteristics, residency status, and language use.


RESULTS
Children were primarily born in the United States (96%), but most parents were not citizens (80%). Only 40.0% of eligible children had continuous Medicaid coverage since birth, 18.6% had never been insured, and 20.7% had received episodic Medicaid coverage. Continuous Medicaid coverage was negatively associated with either the caregiver (odds ratio [OR],0.32; 95% confidence interval [CI], 0.19-0.56) or their partner (OR=0.33, 95% CI =0.20-0.55) working. Residency status, language preference, and length of US residency were not associated with continuous Medicaid enrollment. Insurance coverage was associated with more physician visits, greater continuity of care, and fewer deferrals of care.


CONCLUSIONS
While most (84%) young Latino children in inner-city Los Angeles were eligible for Medicaid, a substantial proportion (39.3%) have episodic or no coverage. Insurance status and provider type were more consistently associated with access rather than residency and language preference. In the aftermath of California's Proposition 187 and federal welfare reform, insurance status and access are likely to worsen for these young children unless the wave of antiimmigration sentiments is held in check.
Halfon
N
N
RAND Health Sciences Program, Santa Monica, CA, USA.
Wood
D L
DL
Valdez
R B
RB
Pereyra
M
M
Duan
N
N
D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D035082:Federal Government; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007348:Insurance, Health; D016013:Likelihood Functions; D015141:Los Angeles / Q000453:epidemiology; D008484:Medicaid / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data