title: Healthcare access and utilization among women 40 and older at the U.S.-Mexico border: predictors of a routine check-up.
abstract: Mexican Americans are more likely to experience barriers to access and utilization of healthcare services than any other U.S. Hispanic group. In Mexico, where the majority of the population has access to care, the pressing issue is the underutilization of preventive services among adults. This study was conducted to assess access and utilization barriers among a U.S.-Mexico border population. A cross-sectional, population-based survey was conducted during 1999-2000 in a pair of contiguous U.S.-Mexico border communities. Household surveys were administered to U.S. and Mexican women, 40 years of age and older, to assess healthcare access and utilization, participation in chronic disease screenings, orientation toward prevention and personal history of chronic disease. Analysis indicates few statistically significant differences (p < 0.05) among access and utilization variables by country. Mexican participants were more likely to have a regular source of care and to have had a blood sugar test within the past 12 months. U.S. participants more often reported having had a Pap smear and mammogram during the previous year. Factors independently positively associated with having had a routine check-up during the past 12 months included age and having a regular provider or place to go when sick. Only going to the doctor when ill was independently inversely associated with routine check-ups in the past 12 months. Findings suggest that U.S. and Mexican border populations are similar with regard to healthcare access and utilization characteristics. Efforts to increase utilization of preventive health screenings among women are needed at the U.S.-Mexico border.
authors.affiliation: Southwest Center for Community Health Promotion, Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson 85721, USA. jhunter@u.arizona.edu
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Hunter
authors.forename: Jill Guernsey
authors.initials: JG
authors.lastname: de Zapien
authors.forename: Catalina A
authors.initials: CA
authors.lastname: Denman
authors.forename: Eva
authors.initials: E
authors.lastname: Moncada
authors.forename: Mary
authors.initials: M
authors.lastname: Papenfuss
authors.forename: Danelle
authors.initials: D
authors.lastname: Wallace
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010808:Physical Examination / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D014626:Vaginal Smears / Q000706:statistics & numerical data