Immigration status and use of health services among Latina women in the San Francisco Bay Area.
OBJECTIVE
To assess the relationship between immigration status and use of health services among Latina women.


METHODS
From 2001 to 2004, information on immigration status and use of health services was collected from 710 Latina women in the San Francisco Bay Area. The dependent variable was use of health services during the previous 12 months, which we defined as use of preventive health, dental, urgent care, and emergency services. The primary independent variable was self-reported immigration status, which we categorized as undocumented immigrant, documented immigrant, or citizen.


RESULTS
More than half of the women were undocumented immigrants, one quarter were documented immigrants, and 18% were citizens. Forty percent of women were uninsured, one third had no preventive health visits in the previous year, and 58% had not used dental services. In adjusted logistic regression analyses, undocumented Latinas were 60% less likely and documented Latinas were 46% less likely to have dental visits in the previous year, relative to citizens. Health insurance status was independently associated with all four health service outcomes. Uninsured women were less likely to use preventive health, dental, or urgent care services compared with privately insured women. In addition, publicly insured women were less likely to use dental care and more likely to use emergency care than privately insured women.


CONCLUSIONS
Immigration and health insurance status were associated with use of preventive and nonpreventive services among Latina women in the San Francisco Bay Area. Clinical and policy efforts must address the barriers to care that affect Latina immigrants, particularly undocumented women.
Fuentes-Afflick
Elena
E
Department of Pediatrics and Epidemiology, University of California, San Francisco, California, USA. efuentes@sfghpeds.ucsf.edu
Hessol
Nancy A
NA
D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D002140:California / Q000453:epidemiology; D003466:Cultural Characteristics; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000208:ethnology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010349:Patient Compliance / Q000208:ethnology; D012959:Socioeconomic Factors; D016387:Women's Health; D055815:Young Adult