Health Care Access and Utilization for Latino Youth in the United States: The Roles of Maternal Citizenship and Distress

Med Care. 2020 Jun;58(6):541-548. doi: 10.1097/MLR.0000000000001306.

Abstract

Objectives: We sought to determine the associations between maternal citizenship and health care access and utilization for US-born Latino youth and to determine whether maternal distress is a moderator of the associations.

Methods: Using 2010-2017 Integrated Public Use Microdata Series National Health Interview Survey data, multivariable logistic regressions were run to examine the associations among maternal citizenship and health care access and utilization for US-born Latino youth. Maternal citizenship and distress interactions were tested.

Results: Noncitizen mothers had higher odds of reporting uninsurance, lack of transportation for delaying care, and lower odds of health care utilization for their youth than citizen mothers. Compared with no distress, moderate and severe distress were positively associated with uninsurance, delayed medical care due to cost, lack of transportation, and having had an emergency department visit for their youth. Moderate distress was positively associated with youth having had a doctor's office visit. Noncitizen mothers with moderate distress were less likely to report their youth having had an emergency department visit than citizen mothers with moderate distress. Among severely distressed mothers, noncitizen mothers were more likely to report youth uninsurance and delayed care due to lack of transportation compared with citizen mothers.

Conclusions: Health care access and utilization among US-born Latino youth are influenced by maternal citizenship and distress. Maternal distress moderates the associations among maternal citizenship and youth's health care access and use. Almost one-third of all US-born youth in the United States are Latino and current federal and state noninclusive immigration policies and anti-Latino immigrant rhetoric may exacerbate health care disparities.