Dental and Medical Access Among the Children of Immigrant and Undocumented Families

Background & Purpose: Scholars, policymakers, and advocates are increasingly concerned about the well-being of undocumented families, families where at least one parent does not have a Visa to legally reside in the United States, particularly those with minor children. In 2008, 4 million children in the U.S. were estimated to have an undocumented parent and the overwhelming majority of these children are themselves U.S. citizens. In addition to barriers to participation in social services such as language, information, and difficult financial constraints, scholars contend that undocumented parents may forego services for their children due to fears of detection of their immigration status. Yet, there is limited empirical evidence of the impact that parental immigration status has on access to services that address health and well-being for their children.

Two areas of particular concern are access to routine medical and dental care for the children of undocumented families. Overall, immigrant adults and children have less access to such services and on average report lower health ratings, especially post-welfare reform which reduced publicly funded programs for immigrant families. Recently, some studies have considered whether such gaps in service are exacerbated for undocumented adults. Limited findings suggest that undocumented adults are less likely to access medical and dental care. Missing from this line of research is information on how parental undocumented immigration status impacts access to dental and medical care for children.

Methods: This paper investigates the extent to which the children of undocumented immigrants have access to routine dental and medical care relative to their peers, all else equal. We investigate access to care using a neighborhoods effects approach in order to account for how place-based disadvantage may shape access to medical and dental services using the first wave of the Los Angeles Families and Neighborhood Survey (LA FANS) data. LA FANS wave 1 data were collected in 2000 and 2001 from 3,085 randomly selected households residing in 65 census tracts in Los Angeles County, California. LA FANS collects information on immigrant status, oversamples low-income and Latino households, and captures information on demographics and neighborhood characteristics. Primary caregiver respondents answered questions regarding the immigration status of the caregiver and child/children, income, work, public program participation, and access to medical and dental services. We focus on families with minor children whose primary caregiver completed all study-related survey questions (n=1,617).  Among our sample, 56 percent are citizens, 23 percent are documented (e.g have a Visa), and the remaining respondents (21 percent) are undocumented.

Results: The children of undocumented immigrants have significantly less access to routine care (medical and dental) despite the fact that the overwhelming majority of these children are themselves U.S. citizens. Neighborhood level factors had only a modest impact on access to care for families.

Conclusions & Implications: We make preliminary recommendations for how policies and programs related to routine care access can be responsive to the needs of these families and their children.