Emergency Room Use by Undocumented Mexican Immigrants

Background and Purpose:

While new Latino immigrants tend to be healthier than the general population, their health deteriorates in time with acculturation (Zsembik & Fennell, 2005). This is often attributed to lack of health insurance and access to health care services (Prentice, Pebley, & Sastryl, 2005). Also, many immigrants are unaware of the health and community resources available to them (Yu, Huang, Schwalber, & Kogan, 2005).

The purpose of this study was: 1) to examine patterns of health seeking behavior among undocumented Mexican immigrants, specifically where they choose to receive health care services; and 2) to ascertain sources of health care information among these immigrants

Methods:

This study is a secondary analysis of the Mexican Migrant Worker Survey conducted by the Pew Hispanic Center (Suro, 2005). The study was a convenience sample of 4,836 Mexican migrants in the United States interviewed while applying for an identity document issued by Mexican consulates. As the immigrants had no legal papers authorizing them to be in the United States, they were assumed to be undocumented or unauthorized.

The dependent variable in this study was the binary variable of choosing ER for medical care. Potential predictors of ER use included gender, age, education, level of income, marital status, employment status, length of residence in U.S., number of children, having family in the same town, and city where data were collected. In addition, analysis controlled for presence of health insurance.

Respondents were asked about the two most important sources from which they receive medical and health information. Analyses included binary variables indicating where information was received, including church, medical care providers, and Mexican and U.S. newspapers.

Multivariate logistical regressions were used to model the relationship between ER use and explanatory variables

Results:

Thirty-eight percent of the respondents reported that they would use hospital ER for medical care. Those aged 29 or younger reported higher ER use rates. Those with one or two children reported the highest ER use rates (40%). ER use rates declined with time spent in the U.S. and varied significantly by data collection site. There were no statistically significant bivariate subgroup variations in ER use by education, level of English, presence of relatives in town/city or fulltime employment status. Reported ER use rates varied significantly according to the data collection site: lowest rates were observed in Los Angeles (33%); whereas in New York, Atlanta and Raleigh, rates were above 45%.

Respondents receiving information from a church reported less ER use; those receiving information from newspapers reported higher ER use rates. Respondents who use churches or medical providers as a source of information had lower odds of reporting ER for medical care.

Conclusions and Implications:

In spite of immigration status, access to quality health care is both a human rights and a public health issue. It is in the best interest of society to offer available and affordable health care. Use of emergency rooms is an expensive, often unnecessary, use of health care resources. Suggestions for further research and policy implications are discussed.