Health Care Experiences of Latino Children in Emerging and Traditional Destinations

Published in: Medical Care, v. 54, no. 5, May 2016, p. 442-448

Posted on RAND.org on April 21, 2016

by Brendan Saloner, Carole Roan Gresenz

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Research Question

  1. Are Latino children living emerging destinations—areas of the United States with newly expanding Latino populations—more vulnerable to poor health experiences and outcomes than their peers in more established Latino communities?

BACKGROUND: Latino populations have disproportionately moved to areas in the Southeast and Midwest (emerging destinations), outside traditional Latino enclaves, in recent years. OBJECTIVE: To examine whether health care experiences differ between traditional and emerging destinations for Latino children. RESEARCH DESIGN: We defined traditional and emerging destination counties based on levels and changes in the Latino population between 2000 and 2010. Measures were linked to the restricted National Survey of Children's Health along with county-level data from the Area Resource File and Census of State and Local Governments. To compare outcomes among Latino children across destinations, linear probability models adjusted for individual-level characteristics, area-level characteristics, and state fixed effects. MEASURES: Outcomes were access to a usual source of care, unmet health care needs, preventive health visit in prior year, and family-centered care. RESULTS: Compared with traditional destination counterparts, Latino children in emerging destinations tended to be younger, healthier, and more likely to be in families speaking English at home. Latino children in emerging destinations were significantly less likely to have a usual source of care adjusting for individual-level and county-level variables, but other dimensions of access were similar between destinations. CONCLUSIONS: Differences in usual source of care may reflect lower supply of culturally competent providers or limited information about where and how to seek care. For realized access to care, protective factors in emerging destinations, such as higher average incomes in the area and lower community uninsurance rates, might counteract any negative effects of emerging destinations.

Key Findings

  • Latino children in emerging destinations differ significantly from their peers in traditional Latino communities: they tend to be younger, less likely to be in a low-income or immigrant family, and less likely to have public health insurance.
  • Latino children in emerging destinations were significantly less likely to have a usual source of care than those in traditional Latino communities.
  • Families living in emerging destinations tend to be more proficient with English, which is associated with greater access to health care but also risk factors such as poor diet.
  • No difference was found in the likelihood of children from either type of location having a regular check-up or having essential health care needs met.
  • Gaps remain in health care access and quality for all Latino children, no matter where they live.

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