Determinants of regular source of health care in black, Mexican, Puerto Rican, and non-Hispanic white populations

Med Care. 1991 Jun;29(6):543-57. doi: 10.1097/00005650-199106000-00013.


Although access to health services has improved considerably in the past two decades, there is growing concern about the locus of health care for the poor and ethnic minorities. In urban areas, in particular, the use of hospital outpatient departments and emergency rooms by the indigent has been increasing. This article examines the determinants of regular source of care and illuminates the ethnicity-poverty-health care nexus. The data set analyzed includes blacks, Mexicans, Puerto Ricans, and non-Hispanic whites residing in poverty areas in Chicago, IL. Multinomial logit analysis is used to estimate the likelihood of having a particular kind of regular source of care. The findings demonstrated considerable ethnic group differences. In particular, blacks tend to utilize hospital facilities as a result of past constraints and their current dependence on public insurance programs. Mexicans are the least likely to have a regular source of care due to social and cultural barriers such as language, migration status, and low community participation. The implications of social isolation associated with poverty are also examined and discussed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans / statistics & numerical data
  • Chicago
  • Child
  • Community Health Centers / statistics & numerical data
  • Data Collection
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Services / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Insurance, Health
  • Male
  • Mexico / ethnology
  • Middle Aged
  • Office Visits / statistics & numerical data
  • Poverty Areas*
  • Puerto Rico / ethnology
  • Social Isolation
  • Socioeconomic Factors
  • Whites / statistics & numerical data