Journal of Immigrant and Minority Health

, Volume 18, Issue 4, pp 928–934

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

Original Paper

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.

Keywords

Immigration status Access to health care Discrimination Healthcare disparities Latinos 

References

  1. 1.
  2. 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. 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. 4.
    Kandel W, Cromartie J. New patterns of hispanic settlement in rural America. Economic Research Service, US Department of Agriculture; 2004. p. 49.Google Scholar
  5. 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.CrossRefGoogle Scholar
  6. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Shavers VL, Shavers BS. Racism and health inequity among Americans. J Natl Med Assoc. 2006;98(3):386–96.PubMedPubMedCentralGoogle Scholar
  9. 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.CrossRefPubMedGoogle Scholar
  10. 10.
    Pérez DJ, Fortuna L, Alegria M. Prevalence and correlates of everyday discrimination among US Latinos. J Commu Psychol. 2008;36(4):421–33.CrossRefGoogle Scholar
  11. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 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.PubMedPubMedCentralGoogle Scholar
  14. 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.CrossRefPubMedGoogle Scholar
  15. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 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.CrossRefGoogle Scholar
  17. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 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.CrossRefPubMedGoogle Scholar
  19. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Consideration of Deferred Action for Childhood Arrivals (DACA). http://www.uscis.gov/humanitarian/consideration-deferred-action-childhood-arrivals-daca.
  21. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 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.CrossRefPubMedGoogle Scholar
  24. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 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.CrossRefPubMedGoogle Scholar
  26. 26.
    Geographic Eligibility for Rural Health Grant Programs. http://datawarehouse.hrsa.gov/ruraladvisor/RuralHealthAdvisor.aspx.
  27. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 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.CrossRefGoogle Scholar
  29. 29.
    Ward LS. Preliminary tests of an ecological model of hispanic farmworker health. Public Health Nurs. 2007;24(6):554–64.CrossRefPubMedGoogle Scholar
  30. 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.CrossRefPubMedGoogle Scholar
  31. 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.PubMedGoogle Scholar
  32. 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.CrossRefGoogle Scholar
  33. 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. 34.
    Pew Research Center. Demographic profile of Hispanics in Oregon, 2011. http://www.pewhispanic.org/states/state/or/.
  35. 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.CrossRefGoogle Scholar
  36. 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.CrossRefGoogle Scholar
  37. 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.CrossRefGoogle Scholar
  38. 38.
    Pandey SK, Cantor JC, Lloyd K. Immigrant Health Care Access and the Affordable Care Act. Public Adm Rev. 2014;74(6):749–59.CrossRefGoogle Scholar
  39. 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.CrossRefGoogle Scholar
  40. 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. 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. 42.
    Gilson L. Trust and the development of health care as a social institution. Soc Sci Med. 2003;56(7):1453–68.CrossRefPubMedGoogle Scholar
  43. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 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.CrossRefPubMedGoogle Scholar
  45. 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.PubMedPubMedCentralGoogle Scholar
  46. 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.CrossRefPubMedGoogle Scholar
  47. 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.CrossRefPubMedGoogle Scholar
  48. 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.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Center for Latino/a Studies and EngagementOregon State UniversityCorvallisUSA
  2. 2.School of Public HealthUniversidad San Francisco de QuitoQuitoEcuador
  3. 3.College of Public Health and Human SciencesOregon State UniversityCorvallisUSA

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