Does Access to Healthcare in Mexico Differentially Influence Parent and Child Health Outcomes?

BACKGROUND

The importance of access to health services was a topic of renewed interest during the spread of COVID-19. One of the struggles seen throughout the course of the pandemic was the negative consequences associated with not having access to good healthcare information and healthcare services. In countries such as Mexico where health services are less accessible compared to neighboring countries such as the US, understanding the impact of accessibility issues is critical when assessing how to improve public health outcomes. This study explores how a family’s access to health services in Mexico differentially influences parent and child health and health-related outcomes. We hypothesized that access to health services would impact parents and children similarly across multiple health indicators such as overall health, mental wellbeing, health literacy, and family functioning.

METHOD

Surveys were emailed to households in Mexico where there was a parent/guardian and a 14-17-year-old youth. Responses were received from 373 parent-child dyads (total N = 746), with data coming from participants living in each Mexican state. Our primary predictor of interest – access to care – included four questions from Levy and Janke’s (2016) article on access to care, and included questions such as, “Was there a time in the past 12 months you needed medical care but did not get it because you could not afford it?”. Dependent variables and controls included demographic indicators such as age, SES, and gender, as well as outcome varaibles of parent-child relationships, health literacy (HL), mental wellbeing, and a global assessment of participant health.

RESULTS

Access to healthcare services predicted parent HL scores on the HLS-Q12 (b = 0.97, p < .01), as well as the functional (b = 0.11, p < .01) and communicative (b = 0.13, p < .001) HL subscales of the AAHLS, but not child health literacy. Similarly, access predicted parent mental wellbeing using the WEMWBS (b = 2.21, p < .01), but not child mental wellbeing. Conversely, access predicted adolescent perspectives of family conflict (b = -0.15, p < .05), but not parent perspectives of family conflict. Access similarly predicted a single-item measure of both child and parent overall health (Parent b = 0.15, p < .01; Child b = 0.11, p < .05).

DISCUSSION

Contrary to our hypothesis, access to healthcare services impacted parents and youth differently. While health – broadly defined – is improved among parents and youth when they have better access to services, knowing the specific sub-domains of health that are enhanced provides a detailed blueprint for change. For example, in rural locations where health services may be sparce, our findings suggest that mental health resources and family conflict prevention measures may be needed in addition to traditional physical health facilities. As it is not possible to distinguish why access to services had so many ancillary benefits for families given the nature of our data, future research should seek to identify the pathways in which mental wellbeing, family functioning, and health literacy are influenced by traditional health facilities in Mexico.