Health Care Access and Utilization and the Latino Health Paradox

Author:

Barajas Clara B.1,Rivera-González Alexandra C.2,Vargas Bustamante Arturo3,Langellier Brent A.1,Lopez Mercado Damaris1,Ponce Ninez A.3,Roby Dylan H.4,Stimpson Jim P.5,De Trinidad Young Maria-Elena2,Ortega Alexander N.6

Affiliation:

1. Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA

2. Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA

3. Department of Health Policy and Management and the Center for Health Policy Research, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA

4. Department of Health, Society, & Behavior, Program in Public Health, University of California, Irvine, Irvine, CA

5. Peter O’Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX

6. Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI

Abstract

Background: The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and US-born Latinos and non-Latino Whites. This study examined whether the paradox holds after accounting for health care access and utilization. Methods: The 2019-2020 National Health Interview Survey data were used. The main predictors included population groups of foreign-born and US-born Latinos (Mexican or non-Mexican) versus US-born non-Latino Whites. Predicted probabilities of health outcomes (self-reported poor/fair health, overweight/obesity, hypertension, coronary heart disease, diabetes, cancer, and depression) were calculated and stratified by length of residence in the United States (<15 or ≥15 years) among foreign-born Latinos and sex (female or male). Multivariable analyses adjusted for having a usual source of care other than the emergency department, health insurance, a doctor visit in the past 12 months, predisposing and enabling factors, and survey year. Results: After adjusting for health care access, utilization, and predisposing and enabling factors, foreign-born Latinos, including those living in the United States ≥15 years, had lower predicted probabilities for most health outcomes than US-born non-Latino Whites, except overweight/obesity and diabetes. US-born Latinos had higher predicted probabilities of overweight/obesity and diabetes and a lower predicted probability of depression than US-born non-Latino Whites. Conclusions: In this national survey, the Latino health paradox was observed after adjusting for health care access and utilization and predisposing and enabling factors, suggesting that, although these are important factors for good health, they do not necessarily explain the paradox.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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