Health care access, use of services, and experiences among undocumented Mexicans and other latinos

Background: We compared access to health care, use of services, and health care experiences for Mexicans and other Latinos by citizenship and immigrant authorization status. Methods: We acquired data from the 2003 California Health Interview Survey, with 42 044 participants representative of noninstitutionalized households. Participants were differentiated by ethnicity/race, national origin, and citizenship/immigration authorization status. Outcome measures included having a usual source of care, problems in obtaining necessary care, use of physician and emergency department care, and 3 experiences with health care. Multivariate analyses measured the associations of citizenship/immigration authorization status with the outcome measures among foreign-born Mexicans and other Latinos vs their US-born counterparts. Results: In multivariate analyses, undocumented Mexicans had 1.6 fewer physician visits (P<.01); compared with US-born Mexicans; other undocumented Latinos had 2.1 fewer visits (P<.01) compared with their US-born counterparts. Both undocumented groups were less likely to report difficulty obtaining necessary health care than US-born Mexicans (odds ratio, 0.68; P<.01) and other US-born Latinos (odds ratio, 0.40; P<.01), respectively. Undocumented Mexicans were less likely to have a usual source of care (odds ratio, 0.70; P<.01) and were more likely to report negative experiences than US-born Mexicans (odds ratio, 1.93; P<.01). Findings were similar for other undocumented Latinos, with the exception of having a usual source of care. Patterns of access to and use of health care services tended to improve with changing legal status. Conclusion: In this large sample, undocumented Mexicans and other undocumented Latinos reported less use of health care services and poorer experiences with care compared with their US-born counterparts, after adjustment for confounders in multivariate analyses.