title: Primary health care utilization by the mexican indigenous population: the role of the Seguro popular in socially inequitable contexts.
abstract: OBJECTIVE
  To analyze the relationship between primary health care utilization and extended health insurance coverage under the Seguro Popular (SP) among Mexican indigenous people.
  
  
  METHODS
  A cross-sectional analysis was conducted using data from the Mexican National Nutrition Survey 2012 (n = 194,758). Quasi-experimental matching methods and nonlinear regression probit models were used to estimate the influence of SP on primary health care utilization.
  
  
  RESULTS
  25% of the Mexican population reported having no health insurance coverage, while 59% of indigenous versus 35% of non-indigenous reported having SP coverage. Health problems were reported by 13.9% of indigenous vs. 10.5% of non-indigenous; of these, 52.8% and 57.7% respectively, received primary health care (p<0.05). Economic barriers were the most frequent reasons for not using primary health care services. The probability of utilizing primary health care services was 11.5 percentage points higher (p<0.01) for indigenous SP affiliates in comparison with non-indigenous, in similar socioeconomic conditions.
  
  
  CONCLUSIONS
  Socioeconomic conditions, not ethnicity per-se, determine whether people utilize primary health care services. Therefore, SP can be conceived as a public policy strategy which acts as a social buffer by enhancing health care utilization regardless of ethnicity. Further analysis is required to explore the potential gaps as a result of SP coverage among socially vulnerable groups.
authors.affiliation: Centre for Health Systems Research of the National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Rene
authors.initials: R
authors.lastname: Leyva-Flores
authors.affiliation: Centre for Health Systems Research of the National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Edson
authors.initials: E
authors.lastname: Servan-Mori
authors.affiliation: Centre for Health Systems Research of the National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Cesar
authors.initials: C
authors.lastname: Infante-Xibille
authors.affiliation: Centre for Health Systems Research of the National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Blanca Estela
authors.initials: BE
authors.lastname: Pelcastre-Villafuerte
authors.affiliation: Centre for Health Systems Research of the National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Tonatiuh
authors.initials: T
authors.lastname: Gonzalez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011320:Primary Health Care; D012959:Socioeconomic Factors
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