Panel Paper: Latino Children's Healthcare in Emerging and Traditional Destinations

Thursday, November 7, 2013 : 9:45 AM
Westview (Ritz Carlton)

*Names in bold indicate Presenter

Brendan Saloner, University of Pennsylvania and Carole Gresenz, Georgetown University
Census 2010 revealed that almost one in four youth in the United States is Latino origin (Passel et al. 2011), representing an immense demographic shift from twenty years ago. The fastest growth among Latino youth has been in “emerging destinations” in the Southeast and Midwest. Settlement in the emerging destination raises important questions about health and healthcare access. While Latino youth have lower overall healthcare access than non-Latino whites, little prior research has considered whether these patterns differ for the emerging destinations.

On the one hand, emerging destinations may have more limited availability of Spanish-speaking providers and fewer community programs for Latinos (Casey et al. 2004). Furthermore, social networks for Latinos in the emerging destinations may be relatively weaker than traditional locales, which could limit information about where to access care (Crowley et al. 2006). On the other hand, if employment opportunities are more favorable for Latinos in the emerging destinations, this could increase their access to insurance and health care, which may countervail other disadvantages.

This study compares the healthcare experiences of Latino youth living in traditional and emerging destinations using data from the 2003, 2007, and 2011-2012 National Survey of Children’s Health (N=37,562). This is one of the first studies that will use the 2011-2012 NSCH. Preliminary analysis (reported here) focuses on state-level differences, comparing the ten states with the largest Latino youth populations in 2000 with the fifteen states that had the highest growth in the percent of Latino youths between 2000 and 2010.  We also have approval to use restricted county-level data (results will be available at the APPAM meeting).

Preliminary analysis finds substantial differences between Latino youth living in traditional versus emerging destinations. Latino youth in new destinations are significantly less likely to have a regular doctor and to have received preventive medical and dental care in the prior year. Adjusting for parent characteristics (such as employment and nativity status), insurance status, and family income partially attenuate these differences, but differences remain significant even after adding these covariates. Parental satisfaction with care (for example, perceptions that providers listen and address family concerns), on the other hand, appears to be equal or greater in emerging destinations. Finally, we compared whether disparities with non-Latino whites (NLWs) were similar in emerging and traditional destinations. Preliminary analysis suggests access disparities with NLWs are wider in new destinations, but perceived quality and satisfaction with care disparities are narrower.

The mixed picture from preliminary analysis suggests that families of Latino youth may encounter more barriers finding adequate care in new destinations, but once in the medical system they are likely to perceive that the care is of higher quality. Future analysis will examine these differences at a more granular level (i.e. counties) and will consider the contribution of contextual variables such as the size of the physician workforce, the safety net, and local economic conditions.