Undocumented Latinos Visit Physicians Less Often Than U.S.-Born Counterparts

Undocumented Mexicans and other undocumented Latinos report less use of health care and poorer experiences with the health care system compared with their counterparts who were born in the United States, according to a report in the November 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

An estimated 8.4 million of the 10.3 million undocumented individuals in the United States are Latino, including 5.9 million from Mexico, according to background information in the article. “One recurrent theme in the debate over immigration has been the use of public services, including health care,” the authors write. “Proponents of restrictive policies have argued that immigrants overuse services, placing an unreasonable burden on the public. Despite a scarcity of well-designed research into these questions regarding immigrants, use of resources continues to be a part of the public debate.”

Alexander N. Ortega, Ph.D., of the University of California, Los Angeles, School of Public Health, and colleagues analyzed data from a 2003 telephone survey of 42,044 California residents designed to represent the state’s entire population. The researchers found that:

  • a total of 1,317 participants were undocumented Mexicans; 2,851 were U.S.-born Mexicans, 271 were undocumented Latinos from other countries and 852 were other Latinos born in the United States
  • undocumented Mexicans had 1.6 fewer physician visits in the past year than Mexicans born in the United States, while other undocumented Latinos had 2.1 fewer physician visits than their U.S.-born counterparts
  • undocumented Mexicans were less likely to have a usual source of care and were more likely to report negative experiences than Mexicans born in the United States
  • patterns of access to and use of health care services tended to improve when legal status changed from undocumented to green card or naturalized citizens
  • undocumented Latinos reported less difficulty obtaining necessary health care than U.S.-born Latinos. This seemingly counterintuitive finding could have occurred because they are less likely to seek care than U.S.-born Latinos or because the U.S. health care system compares favorably to the systems in their home countries, the authors note.

The results have implications for addressing health care disparities, they continue. “For example, worse health care experiences for undocumented Mexicans imply that efforts to improve processes of care need to address this specific vulnerable group,” the authors write. “Strategies to improve the delivery of health care services to legally authorized immigrants and U.S. citizens, to the exclusion of undocumented individuals, will likely miss an opportunity to influence health care for the individuals most affected by inequities in health care access.”

“Low rates of use of health care services by Mexican immigrants and similar trends among other Latinos do not support public concern about immigrants’ overuse of the health care system,” they conclude.

Arch Intern Med. 2007; 167(21):2354-2360.