Access to Health Services Among US Immigrant Children and Families

Background and Purpose: In 2019, there were approximately 45 million immigrants in the United States, with 17.8 million children living in a household with at least one immigrant parent (Bolter, 2020). Despite the growing number of immigrants in the United States, immigrants struggle to access health care services due to concerns with insurance eligibility, transportation, language, socioeconomic status, immigration policies, limited health literacy, and acculturation challenges. This study describes the sociodemographic and health characteristics of immigrant families and examines the association between immigration status and access to health services.

Methods: We used data from the cross-sectional 2018 National Survey of Children's Health (NCHS), a nationally representative survey of 30,530 children in the United States. Our independent variable, immigration status was defined as having at least one parent or a child born outside of the United States. We used multivariate logistic regression to evaluate the odds of access to health services defined as having a primary care provider, routine medical check-ups, and a regular medical location for healthcare needs.

Results: We found that immigrant families are less likely to have access to health services compared to nonimmigrant families, including accessing routine medical check-ups (OR = 0.83, 95% CI = 0.76- 0.91) and having a regular medical location for healthcare needs (OR = 0.75, 95% CI = 0.69-0.82). Other significant predictors of poor health care access were being Black or of other race compared to white; having a primary language spoken other than English compared to English speaking households; parents with less than high school, high school, and some college or associate degree compared to a college degree; family structures with two parents not married, single mother or other family structures compared to two parents who were currently married.

Conclusion and Implications: Findings from this large population-based survey suggest immigrant families’ access to healthcare is limited. At the same time, other factors, including social determinants of health (SDOH), such as race and ethnicity, language spoken at home, family structure, and education level are strongly associated with access to health services. Social workers should consider targeted advocacy and interventions that center SDOH and immigrant families to increase resources and services for the most vulnerable populations.