Access to and use of health services among undocumented Mexican immigrants in a US urban area.
OBJECTIVE
We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004.


METHODS
We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care.


RESULTS
In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care.


CONCLUSIONS
Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population.
Nandi
Arijit
A
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Galea
Sandro
S
Lopez
Gerald
G
Nandi
Vijay
V
Strongarone
Stacey
S
Ompad
Danielle C
DC
D000069:Acculturation; D000293:Adolescent; D000328:Adult; D019352:Censuses; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004641:Emigration and Immigration; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D007407:Interviews as Topic; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City; D011203:Poverty; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D019037:Urban Health Services / Q000706:statistics & numerical data*