title: Persistent disparities in the use of health care along the US-Mexico border: an ecological perspective.
abstract: OBJECTIVE
  We examined disparities in health care use among US-Mexico border residents, with a focus on the unique binational environment of the region, to determine factors that may influence health care use in Mexico.
  
  
  METHODS
  Data were from 2 waves of a population-based study of 1048 Latino residents of selected Texas border counties. Logistic regression models examined predictors of health insurance coverage. Results from these models were used to examine regional patterns of health care use.
  
  
  RESULTS
  Of the respondents younger than 65 years, 60% reported no health insurance coverage. The uninsured were 7 and 3 times more likely in waves 3 and 4, respectively, to use medical care in Mexico than were the insured. Preference for medical care in Mexico was an important predictor.
  
  
  CONCLUSIONS
  For those who were chronically ill, old, poor, or burdened by the lengthy processing of their documents by immigration authorities, the United States provided the only source of health care. For some, Mexico may lessen the burden at the individual level, but it does not lessen the aggregate burden of providing highly priced care to the region's neediest. Health disparities will continue unless policies are enacted to expand health care accessibility in the region.
authors.affiliation: Department of Sociology, University of Texas-Pan American, Center on Aging and Health, Edinburg. bastida@hsc.unt.edu
authors.forename: Elena
authors.initials: E
authors.lastname: Bastida
authors.forename: H Shelton
authors.initials: HS
authors.lastname: Brown
authors.forename: José A
authors.initials: JA
authors.lastname: Pagán
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D019458:Insurance Coverage / Q000145:classification / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D017057:Medically Uninsured / Q000208:ethnology / Q000706:statistics & numerical data; D006278:Medicare; D017058:Mexican Americans / Q000523:psychology / Q000706:statistics & numerical data; D008800:Mexico; D008875:Middle Aged; D009042:Motivation; D011331:Private Practice; D013781:Texas; D014481:United States
references.citation: Clin Ther. 2003 Feb;25(2):561-77; discussion 560
references.pmid: 12749514
references.citation: JAMA. 1991 Jan 9;265(2):242-7
references.pmid: 1984155
references.citation: Health Aff (Millwood). 2006 Nov-Dec;25(6):w476-85
references.pmid: 17003075
references.citation: Health Aff (Millwood). 2005 Sep-Oct;24(5):1273-80
references.pmid: 16162573
references.citation: Clin Ther. 1996 Nov-Dec;18(6):1242-51
references.pmid: 9001840
references.citation: Health Econ. 2005 May;14(5):537-44
references.pmid: 15497131
references.citation: Health Mark Q. 2002;20(1):3-16
references.pmid: 12749595
references.citation: South Med J. 1990 Mar;83(3):271-3
references.pmid: 2315770
references.citation: Gerontologist. 1996 Jun;36(3):332-40
references.pmid: 8682331
references.citation: J Health Care Poor Underserved. 2001 Feb;12(1):77-87
references.pmid: 11217230
references.citation: Health Aff (Millwood). 2006 Nov-Dec;25(6):1612-9
references.pmid: 17102186
references.citation: West J Med. 1992 May;156(5):512-6
references.pmid: 1595276
references.citation: JAMA. 1991 Jan 9;265(2):233-7
references.pmid: 1984153
references.citation: Contraception. 2003 Oct;68(4):281-7
references.pmid: 14572892
references.citation: Time. 1987 Jun 15;129(24):60
references.pmid: 10282042
references.citation: J Community Health. 2001 Apr;26(2):123-32
references.pmid: 11322752
references.citation: Health Econ. 2002 Jul;11(5):403-13
references.pmid: 12112490