Skip to main content

Advertisement

SpringerLink
Log in

Foreign-Born Latinos Living in Rural Areas are more likely to Experience Health Care Discrimination: Results from Proyecto de Salud para Latinos

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Health care discrimination is increasingly considered a significant barrier to accessing health services among minority populations, including Latinos. However, little is known about the role of immigration status. The purpose of this study was to examine the association between immigration status and perceived health care discrimination among Latinos living in rural areas. Interviews were conducted among 349 young-adult Latinos (ages 18 to 25) living in rural Oregon, as part of Proyecto de Salud para Latinos. Over a third of participants experienced health care discrimination (39.5 %). Discrimination was higher among foreign-born (44.9 %) rather than US-born Latinos (31.9 %). Multivariate results showed that foreign-born Latinos were significantly more likely to experience health care discrimination, even after controlling for other relevant factors (OR = 2.10, 95 % CI 1.16–3.82). This study provides evidence that health care discrimination is prevalent among young-adult Latinos living in rural areas, particularly the foreign-born. Effective approaches towards reducing discrimination in health care settings should take into consideration the need to reform our broken immigration system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. USA QuickFacts. http://quickfacts.census.gov/qfd/states/00000.html.

  2. Krogstad JM, Lopez MH. Hispanic Nativity Shift: US births drive population growth as immigration stalls. Washington, DC: Pew Research Center; 2014.

    Google Scholar 

  3. Motel S, Patten E. Statistical Portrait of Hispanics in the United States, 2011 In. Washington, DC: Pew Research Hispanic Center; 2013. p. 45.

    Google Scholar 

  4. Kandel W, Cromartie J. New patterns of hispanic settlement in rural America. Economic Research Service, US Department of Agriculture; 2004. p. 49.

  5. Vásquez MA, Seales CE, Marquardt MF. New Latino destinations. In: Rodríguez CE, Massey DS, Rodriguez H, Saenz R, Menjivar C, editors. Latinas/os in the United States: changing the face of America. Berlin: Springer; 2008. p. 19–35.

    Chapter  Google Scholar 

  6. Suro R, Tafoya S. Dispersal and concentration: patterns of Latino residential settlement. Washington, DC: Pew Research Hispanic Center; 2004. p. 23.

    Google Scholar 

  7. Shavers VL, Fagan P, Jones D, Klein WMP, Boyington J, Moten C, Rorie E. The state of research on racial/ethnic discrimination in the receipt of health care. Am J Public Health. 2012;102(5):953–66.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shavers VL, Shavers BS. Racism and health inequity among Americans. J Natl Med Assoc. 2006;98(3):386–96.

    PubMed  PubMed Central  Google Scholar 

  9. LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000;57(4 suppl):146–61.

    Article  PubMed  Google Scholar 

  10. Pérez DJ, Fortuna L, Alegria M. Prevalence and correlates of everyday discrimination among US Latinos. J Commu Psychol. 2008;36(4):421–33.

    Article  Google Scholar 

  11. Smedley BD, Stith AY, Nelson AR. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press; 2009.

    Google Scholar 

  12. Armstrong K, Putt M, Halbert CH, Grande D, Schwartz JS, Liao K, Marcus N, Demeter MB, Shea JA. Prior experiences of racial discrimination and racial differences in health care system distrust. Med Care. 2013;51(2):144–50.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bachhuber MA, Tschannerl A, Lechuga C, Anderson M. Racial discrimination in health care settings: Does insurance matter? Am J Public Health. 2014. doi:10.2105/AJPH.2013.301777.

    PubMed  PubMed Central  Google Scholar 

  14. Benjamins MR. Race/ethnic discrimination and preventive service utilization in a sample of whites, blacks, Mexicans, and Puerto Ricans. Med Care. 2012;50(10):870–6.

    Article  PubMed  Google Scholar 

  15. Cuffee YL, Hargraves JL, Rosal M, Briesacher BA, Schoenthaler A, Person S, Hullett S, Allison J. Reported racial discrimination, trust in physicians, and medication adherence among inner-city african americans with hypertension. Am J Public Health. 2013;103(11):e55–62.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gonzales KL, Harding AK, Lambert WE, Fu R, Henderson WG. Perceived experiences of discrimination in health care: a barrier for cancer screening among American indian women with type 2 diabetes. Women Health Issues. 2013;23(1):e61–7.

    Article  Google Scholar 

  17. Shavers VL, Klein WMP, Fagan P. Research on race/ethnicity and health care discrimination: where we are and where we need to go. Am J Public Health. 2012;102(5):930–2.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Viruell-Fuentes EA. Beyond acculturation: immigration, discrimination, and health research among Mexicans in the United States. Soc Sci Med. 2007;65(7):1524–35.

    Article  PubMed  Google Scholar 

  19. Zambrana RE, Carter-Pokras O. Role of acculturation research in advancing science and practice in reducing health care disparities among Latinos. Am J Public Health. 2010;100(1):18.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Consideration of Deferred Action for Childhood Arrivals (DACA). http://www.uscis.gov/humanitarian/consideration-deferred-action-childhood-arrivals-daca.

  21. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization; 2008. p. 256.

    Google Scholar 

  22. Blair IV, Steiner JF, Fairclough DL, Hanratty R, Price DW, Hirsh HK, Wright LA, Bronsert M, Karimkhani E, Magid DJ, et al. Clinicians’ implicit ethnic/racial bias and perceptions of care among black and Latino patients. Ann Fam Med. 2013;11(1):43–52.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lauderdale DS, Wen M, Jacobs EA, Kandula NR. Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003. Med Care. 2006;44(10):914–20.

    Article  PubMed  Google Scholar 

  24. Perez DJ, Sribney W, Rodríguez M. Perceived discrimination and self-reported quality of care among Latinos in the United States. J Gen Intern Med. 2009;24(3):548–54.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Warren JT, Harvey SM, Bovbjerg ML. Characteristics related to effective contraceptive use among a sample of nonurban Latinos. Perspect Sex Reprod Health. 2011;43(4):255–62.

    Article  PubMed  Google Scholar 

  26. Geographic Eligibility for Rural Health Grant Programs. http://datawarehouse.hrsa.gov/ruraladvisor/RuralHealthAdvisor.aspx.

  27. Aday LA, Chiu GY, Andersen R. Methodological issues in health care surveys of the Spanish heritage population. Am J Public Health. 1980;70(4):367–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Harvey SM, Branch MR, Hudson D, Torres A. Listening to immigrant Latino men in rural Oregon exploring connections between culture and sexual and reproductive health services. Am J Men Health. 2013;7(2):142–54.

    Article  Google Scholar 

  29. Ward LS. Preliminary tests of an ecological model of hispanic farmworker health. Public Health Nurs. 2007;24(6):554–64.

    Article  PubMed  Google Scholar 

  30. Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM. Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Soc Sci Med. 2005;61(7):1576–96.

    Article  PubMed  Google Scholar 

  31. Bird ST, Bogart LM. Perceived race-based and socioeconomic status(SES)-based discrimination in interactions with health care providers. Ethn Dis. 2001;11(3):554–63.

    CAS  PubMed  Google Scholar 

  32. Marin G, Sabogal F, Marin BV, Otero-Sabogal R, Perez-Stable EJ. Development of a short acculturation scale for Hispanics. Hisp J Behav Sci. 1987;9(2):183–205.

    Article  Google Scholar 

  33. Archer KJ, Lemeshow S. Goodness-of-fit test for a logistic regression model fitted using survey sample data. The Stata Journal. 2006;6(1):97–105.

    Google Scholar 

  34. Pew Research Center. Demographic profile of Hispanics in Oregon, 2011. http://www.pewhispanic.org/states/state/or/.

  35. Cristancho S, Peters KE, Garcés DM. Latinos in rural areas: addressing mental health disparities in new growth communities. In: Buki LP, Piedra LM, editors. Creating infrastructures for Latino Mental Health. Berlin: Springer; 2011. p. 215–31.

    Chapter  Google Scholar 

  36. Messias DKH, McEwen MM, Clark L. The impact and implications of undocumented immigration on individual and collective health in the United States. Nurs Outlook. 2015;63(1):86–94. doi:10.1016/j.outlook.2014.1011.1004.

    Article  Google Scholar 

  37. Bustamante AV, Fang H, Garza J, Carter-Pokras O, Wallace SP, Rizzo JA, Ortega AN. Variations in healthcare access and utilization among Mexican immigrants: the role of documentation status. J Immigr Minor Health. 2012;14(1):146–55.

    Article  Google Scholar 

  38. Pandey SK, Cantor JC, Lloyd K. Immigrant Health Care Access and the Affordable Care Act. Public Adm Rev. 2014;74(6):749–59.

    Article  Google Scholar 

  39. Pourat N, Wallace SP, Hadler MW, Ponce N. Assessing health care services used by California’s undocumented immigrant population in 2010. Health Aff. 2014;33(5):840–7.

    Article  Google Scholar 

  40. Fix ME, Zimmermann W. All under one roof: mixed-status families in an era of reform. Washington, D.C.: The Urban Institute; 1999.

    Google Scholar 

  41. Capps R, Fix ME, Ost J, Reardon-Anderson J, Passel JS. The health and well-being of young children of immigrants. Washington, D.C.: The Urban Institute; 2005. p. 57.

    Google Scholar 

  42. Gilson L. Trust and the development of health care as a social institution. Soc Sci Med. 2003;56(7):1453–68.

    Article  PubMed  Google Scholar 

  43. Documėt PI, Kamouyerou A, Pesantes A, Macia L, Maldonado H, Fox A, Bachurski L, Morgenstern D, Gonzalez M, Boyzo R. Participatory assessment of the health of Latino immigrant men in a community with a growing Latino population. J Immigr Minor Health. 2015;17(1):239–47.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Paradies Y, Truong M, Priest N. A systematic review of the extent and measurement of healthcare provider racism. J Gen Intern Med. 2014;29(2):364–87.

    Article  PubMed  Google Scholar 

  45. Peek ME, Nunez-Smith M, Drum M, Lewis TT. Adapting the Everyday Discrimination Scale to medical settings: reliability and validity testing in a sample of African American patients. Ethn Dis. 2011;21(4):502–9.

    PubMed  PubMed Central  Google Scholar 

  46. Johnson JL, Bottorff JL, Browne AJ, Grewal S, Hilton BA, Clarke H. Othering and being othered in the context of health care services. Health Commun. 2004;16(2):255–71.

    Article  PubMed  Google Scholar 

  47. Branch M, Harvey SM, Zukoski AP, Warren J. Prevention of unintended pregnancy and hiv/stis among Latinos in rural communities: perspectives of health care providers. Health Care Women Int. 2010;31(8):718–36.

    Article  PubMed  Google Scholar 

  48. Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012;75(12):2099–106.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the study participants in the four Oregon counties who took the time to answer our questions. Support for this study was provided by cooperative agreement U01DP000123A from the Centers for Disease Control and Prevention (CDC) to S. Marie Harvey (PI). Dr. López-Cevallos was supported in part by the Summer Institute on Mentoring Researchers in Latino Health Disparities at San Diego State University (R25HL105430). The views expressed in this article are the responsibility solely of the authors and do not necessarily represent the official views of the CDC.

Author information

Authors and Affiliations

  1. Center for Latino/a Studies and Engagement, Oregon State University, 262 Waldo Hall, Corvallis, OR, 97331, USA

    Daniel F. López-Cevallos

  2. School of Public Health, Universidad San Francisco de Quito, Diego de Robles y Vía Interoceánica, Quito, Ecuador

    Daniel F. López-Cevallos

  3. College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

    S. Marie Harvey

Authors
  1. Daniel F. López-Cevallos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Marie Harvey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel F. López-Cevallos.

Ethics declarations

Conflict of interest

The authors declare that they do not have a conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

López-Cevallos, D.F., Harvey, S.M. Foreign-Born Latinos Living in Rural Areas are more likely to Experience Health Care Discrimination: Results from Proyecto de Salud para Latinos . J Immigrant Minority Health 18, 928–934 (2016). https://doi.org/10.1007/s10903-015-0281-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-015-0281-2

Keywords

Search

Navigation