Brendan Saloner1, Carole Roan Gresenz. 1. *Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD†RAND Corporation, Arlington, VA.
Abstract
BACKGROUND: Latino populations have disproportionately moved to areas in the Southeast and Midwest (emerging destinations), outside traditional Latino enclaves, in recent years. OBJECTIVE: To examine whether health care experiences differ between traditional and emerging destinations for Latino children. RESEARCH DESIGN: We defined traditional and emerging destination counties based on levels and changes in the Latino population between 2000 and 2010. Measures were linked to the restricted National Survey of Children's Health along with county-level data from the Area Resource File and Census of State and Local Governments. To compare outcomes among Latino children across destinations, linear probability models adjusted for individual-level characteristics, area-level characteristics, and state fixed effects. MEASURES: Outcomes were access to a usual source of care, unmet health care needs, preventive health visit in prior year, and family-centered care. RESULTS: Compared with traditional destination counterparts, Latino children in emerging destinations tended to be younger, healthier, and more likely to be in families speaking English at home. Latino children in emerging destinations were significantly less likely to have a usual source of care adjusting for individual-level and county-level variables, but other dimensions of access were similar between destinations. CONCLUSIONS: Differences in usual source of care may reflect lower supply of culturally competent providers or limited information about where and how to seek care. For realized access to care, protective factors in emerging destinations, such as higher average incomes in the area and lower community uninsurance rates, might counteract any negative effects of emerging destinations.
BACKGROUND: Latino populations have disproportionately moved to areas in the Southeast and Midwest (emerging destinations), outside traditional Latino enclaves, in recent years. OBJECTIVE: To examine whether health care experiences differ between traditional and emerging destinations for Latino children. RESEARCH DESIGN: We defined traditional and emerging destination counties based on levels and changes in the Latino population between 2000 and 2010. Measures were linked to the restricted National Survey of Children's Health along with county-level data from the Area Resource File and Census of State and Local Governments. To compare outcomes among Latino children across destinations, linear probability models adjusted for individual-level characteristics, area-level characteristics, and state fixed effects. MEASURES: Outcomes were access to a usual source of care, unmet health care needs, preventive health visit in prior year, and family-centered care. RESULTS: Compared with traditional destination counterparts, Latino children in emerging destinations tended to be younger, healthier, and more likely to be in families speaking English at home. Latino children in emerging destinations were significantly less likely to have a usual source of care adjusting for individual-level and county-level variables, but other dimensions of access were similar between destinations. CONCLUSIONS: Differences in usual source of care may reflect lower supply of culturally competent providers or limited information about where and how to seek care. For realized access to care, protective factors in emerging destinations, such as higher average incomes in the area and lower community uninsurance rates, might counteract any negative effects of emerging destinations.
Authors: Julie H Levison; Laura M Bogart; Iman F Khan; Dianna Mejia; Hortensia Amaro; Margarita Alegría; Steven Safren Journal: AIDS Patient Care STDS Date: 2017-09 Impact factor: 5.078