Variations in Healthcare Access and Utilization Among Mexican Immigrants: The Role of Documentation Status

TLDR

The study aims to compare healthcare access and utilization between documented and undocumented Mexican immigrants. Using 2007 California Health Interview Survey data, the authors applied multivariable logistic regression and Blinder‑Oaxaca decomposition to compare documented and undocumented Mexican immigrants aged 18+ in California. Undocumented Mexican immigrants were 27% less likely to have a doctor visit and 35% less likely to have a usual source of care, with 88% of the gap explained by observed factors and the remainder by unobserved heterogeneity; the ACA will not close these gaps without legal status.

Abstract

The objective of this study is to identify differences in healthcare access and utilization among Mexican immigrants by documentation status. Cross-sectional survey data are analyzed to identify differences in healthcare access and utilization across Mexican immigrant categories. Multivariable logistic regression and the Blinder-Oaxaca decomposition are used to parse out differences into observed and unobserved components. Mexican immigrants ages 18 and above who are immigrants of California households and responded to the 2007 California Health Interview Survey (2,600 documented and 1,038 undocumented immigrants). Undocumented immigrants from Mexico are 27% less likely to have a doctor visit in the previous year and 35% less likely to have a usual source of care compared to documented Mexican immigrants after controlling for confounding variables. Approximately 88% of these disparities can be attributed to predisposing, enabling and need determinants in our model. The remaining disparities are attributed to unobserved heterogeneity. This study shows that undocumented immigrants from Mexico are much less likely to have a physician visit in the previous year and a usual source of care compared to documented immigrants from Mexico. The recently approved Patient Protection and Affordable Care Act will not reduce these disparities unless undocumented immigrants are granted some form of legal status.