Immigration Legal Status and Use of Public Programs and Prenatal Care

Paul L. Geltman1,2, Alan F. Meyers2
1Massachusetts Dept. of Public Health, Refugee and Immigrant Health Program, Jamaica Plain
2Divisions of Community and General Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston

Tóm tắt

This study assessed impacts of immigrants' legal status on utilization of prenatal care and public programs by non-citizen women. Interviews and chart reviews of 171 women were conducted less than 48 hours after delivery at an urban hospital. Among non-citizens, 67% were legally documented. No differences in prenatal care adequacy by legal status were detected among non-citizens, who as a group had less health insurance, worse socioeconomics, and less program use compared to U.S. citizens. Non-citizens also were less aware of newborn's citizenship and eligibility for public programs and benefits. Non-citizens utilized fewer programs while reporting greater economic hardship than citizens; however, non-citizens selectively used programs important for pregnancy. Given changes in eligibility for federal programs and high rates of reported food insecurity and socioeconomic hardship among non-citizens, monitoring for adverse effects on utilization of prenatal care and birth outcomes is needed.

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Tài liệu tham khảo

Asch S, Leake B, Gelberg L: Does fear of immigration authorities deter tuberculosis patients from seeking care? West J Med 1994; 161:373–376

Nagi SZ, Haavio-Mannila E: Migration, health status, and utilization of health services. Sociol Health Illness 1980; 2:174–193

Stephen EH, Foote K, Hendershot GE, Schoenborn CA: Health of the foreign-born population: United States, 1989–90. Hyattsville, MD: National Center for Health Statistics; 1994

Cabral H, Fried LE, Levenson S, Amaro H, Zuckerman B: Foreign-born and US-born women: Differences in health behaviors and birth outcomes. Am J Public Health 1990; 80:70–72

Cobas JA, Balcazar H, Benin MB, Keith VM, Chong Y: Acculturation and low-birthweight infants among Latino women: A reanalysis of HHANES data with structural equation models. Am J Public Health 1996; 86:394–396

Scribner R: Paradox as paradigm—The health outcomes of Mexican Americans (editorial). Am J Public Health 1996; 86;303–305

Weitzman BC, Berry AC: Health status and health care utilization among New York City home attendants: An illustration of the needs of working poor, immigrant women. Women Health 1992; 19:87–105

Chavez LR, Cornelius WA, Jones OW: Utilization of health services by Mexican immigrant women in San Diego. Women Health 1986; 11:3–20

Hubbell FA, Waitzman H, Mishra SI, Dombrink J, Chavez LR: Access to medical care for documented and undocumented Latinos in a southern California county. West J Med 1991; 154:414–417

Thamer M, Christian R, Casebeer AW, Ray NF: Health insurance coverage among foreign-born US residents: The impact of race, ethnicity, and length of residence. Am J Public Health 1997; 87:96–102

Halfon N, Wood DL, Burciaga Valdez R, Pereyra M, Duan N: Medicaid enrollment and health services access by Latino children in inner-city Los Angeles. JAMA 1997; 277:636–641

Minkoff H, Bauer T, Joyce T: Welfare reform and the obstetrical care of immigrants and their newborns. N Eng J Med 1997; 337:705–707

Chavez LR, Cornelius WA, Jones OW: Mexican immigrants and the utilization of U.S. health services: The case of San Diego. Soc Sci Med 1985; 21:93–102

Chi PSK: Medical utilization patterns of migrant farm workers in Wayne County, New York. Public Health Rep 1985; 100:480–490

Edwards N: Factors influencing prenatal class attendance among immigrants in Ottawa-Carleton. Can J Public Health 1994; 85:254–258

Faller HS: Perinatal needs of immigrant Hmong women: Surveys of women and health care providers. Public Health Rep 1985; 100:340–343

Weeks JR, Rumbaut RG: Infant mortality among ethnic immigrant groups. Soc Sci Med 1991; 33:327–334

Baker DW, Parker RM, Williams MV, Coates WC, Pitkin K: Use and effectiveness of interpreters in an emergency department. JAMA 1996; 275:783–788

Benson V, Marano MA: Current estimates from the National Health Interview Survey, 1993. National Center for Health Statistics. Vital Health Stat 1994; 10:190

National Health and Nutrition Examination Survey III Data Collection Forms. Hyattsville, MD: National Center for Health Statistics; 1990

Wehler CA, Scott RI, Anderson JJ, Summer L, Parker L: Community Childhood Hunger Identification Project. A Survey of Childhood Hunger in the United States. Washington, DC: Food Research and Action Center; 1995

Lipson JG, Meleis AI: Methodological issues in research with immigrants. Med Anthropol 1989; 12:103–115

Sankar A: Culture, research, and policy. Gerontologist. 1993; 33:437–438

Alexander GR, Kotelchuck M: Quantifying the adequacy of prenatal care: A comparison of indices. Public Health Rep 1996; 111:408–418

Kotlechuck M: An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. Am J Public Health 1994; 84:1414–1420

DeVille K: Parties to the social contract? Justice, Proposition 187 and health care for undocumented immigrants. Trends Health Care Law Ethics 1995; 10:113–118