title: Parental nativity is an important factor associated with where children usually go for health care.
abstract: OBJECTIVE
  Few studies of children's access to care account for the independent effects of parental immigration characteristics. To address this gap in knowledge, we examine the association between parental nativity and where children usually obtain health care.
  
  
  METHODS
  The 2002 National Survey of America's Families (N = 34,332).
  
  
  RESULTS
  Fourteen percent of the sampled children had only foreign-born parents. Most of the sampled children used physician's offices or HMOs (69%) and clinics or other hospital outpatient settings (24%) as usual sites for health care; few used hospital emergency departments or other care providers (1.4%). After adjusting for confounders, using multinomial logistic regression, both citizen [OR = 1.92 (1.44-2.56)] and non-citizen [OR = 5.21 (3.33-8.15)] children with foreign-born parents were more likely to lack a usual site for health care, compared to children with at least one US-born parent-regardless of the mother's citizenship and duration of stay in the US. After accounting for parental nativity, lack of citizenship and shorter durations of US stay among mothers were associated with children's greater use of public clinics or other hospital outpatient settings, rather than physician's offices or HMOs. The effect of parental nativity persisted for minority, but not white, children; however, non-citizen children lacked a usual site for health care regardless of their race and ethnicity.
  
  
  CONCLUSIONS
  The immigration characteristics of parents are important to disparities in where children usually go for health care. These results suggest that increasing the "biomedical acculturation" of immigrant mothers may improve access to care for their children.
authors.affiliation: Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. andrea_weathers@unc.edu
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Weathers
authors.forename: Scott P
authors.initials: SP
authors.lastname: Novak
authors.forename: Narayan
authors.initials: N
authors.lastname: Sastry
authors.forename: Edward C
authors.initials: EC
authors.lastname: Norton
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States