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The Role of Acculturation and Social Capital in Access to Health Care: A Meta-study on Hispanics in the US

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Abstract

A meta-study of 83 articles published from 1981 to 2016 was conducted on Hispanics access to health care in the US. Few of these studies have included acculturation and even fewer the role of social capital as important factors that impact healthcare access for this population. Among those that do include these two factors, there is confusion as to how they are defined and operationalized. Acculturation and social capital could serve to overcome some of the structural barriers in place that manifest stronger among Hispanics who are relatively newcomers to a healthcare system that is highly complex to navigate. The majority of studies included in this systematic review of the literature are in public health journals, which do not focus on sociological aspects as much. This study exposes the need to expand the worldviews used in the literature in order to enrich our understanding of access to health care for Hispanics.

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Notes

  1. In this paper we use the term Hispanic and Latinx interchangeably to refer to the population in the US that self-classify themselves as immigrants or descendants of immigrants from Latin American countries, mostly those that have been colonized by Spain. We recognize these terms are context based (i.e. they vary in their definition in other parts of the world).

  2. The centers include: UCLA Center for Health Policy Research, The Commonwealth Foundation, Health Research and Educational Trust, and The Henry J. Kaiser Family Foundation.

  3. In the introduction we presented the following numbers to illustrate the differences. Hispanics consistently show the highest rates of uninsured (29%) when compared to non-Hispanic-white (11%), blacks (19%), or Asian (15%) [8], [9].

  4. Examples may help in understanding the impact of such. Puerto Ricans for instance, are American citizens, so they qualify for public health insurance. Mexican immigrants are usually a target of discrimination through immigration and healthcare legislation. Hence, Mexican immigrants, if undocumented do not have access to public health insurance as Puerto Ricans do [68]. During the Cold War, Cubans who migrated to the US were given a refugee status and several preferential treatments, including gaining quick citizenship status. In addition, most of the Cubans who migrated to the US were of higher socioeconomic status with higher educational levels. As a result, Cubans gained access to things that Mexican immigrants of low socioeconomic status and lower educational levels do not have, such as access to medical insurance [69].

References

  1. Escarce, J. J., & Kapur, K. (2006). Access to and quality of health care. In M. Tienda & F. Mitchell (Eds.), Hispanics and the future of America. Washington, D.C.: National Academies Press.

    Google Scholar 

  2. Andersen, R., Lewis, S. Z., Giachello, A. L., Aday, L. A., & Chiu, G. (1981). Access to medical care among the Hispanic population of the southwestern United States. Journal of Health and Social Behavior, 22(1), 78.

    CAS  PubMed  Google Scholar 

  3. Andersen, R. M., Giachello, A. L., & Aday, L. A. (1986). Access of Hispanics to health care and cuts in services: A state-of-the-art overview. Public Health Reports, 101(3), 238–252.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Balcazar, A. J., Grineski, S. E., & Collins, T. W. (2015). The durability of immigration-related barriers to health care access for Hispanics across generations. Hispanic Journal of Behavioral Sciences, 37(1), 118–135.

    Google Scholar 

  5. Fiscella, K., Franks, P., Doescher, M. P., & Saver, B. G. (2002). Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Medical Care, 40(1), 52–59.

    PubMed  Google Scholar 

  6. Gresenz, C. R., Rogowski, J., & Escarce, J. J. (2009). Community demographics and access to health care among U.S. Hispanics. Health Research and Educational Trust, 44(5), 1542–1562.

    Google Scholar 

  7. Livingston, G. (2009). Hispanics, health insurance and health care access. Washington, DC: Pew Research Center.

    Google Scholar 

  8. DeNavas-Walt, C., Proctor, B. D., & Smith, J. C. (2013). Income, poverty, and health insurance coverage in the United States: 2012. Washington, D.C.: U.S. Census Bureau.

    Google Scholar 

  9. Doty, M. M., & Holmgren, A. L. (2006). Health care disconnect: Gaps in coverage and care for minority adults. New York: The Commonwealth Fund.

    Google Scholar 

  10. Macias, E. P., & Morales, L. S. (2001). Crossing the border for health care. Journal of Health Care for the Poor and Underserved, 12(1), 77–87.

    CAS  PubMed  Google Scholar 

  11. Callahan, S. T., & Cooper, W. O. (2004). Gender and uninsurance among young adults in the United States. Pediatrics, 113(2), 291–297.

    PubMed  Google Scholar 

  12. Heyman, J. M., Núñez, G. G., & Talavera, V. (2009). Healthcare access and barriers for unauthorized immigrants in El Paso County, Texas. Fam. Community Health, 32(1), 4–21.

    PubMed  Google Scholar 

  13. Documet, P. I., & Sharma, R. K. (2004). Latinos’ health care access: Financial and cultural barriers. Journal of Immigrant Health, 6(1), 5–13.

    PubMed  Google Scholar 

  14. Fronstin, P. (2013). Sources of health insurance and characteristics of the uninsured: analysis of the March 2011 current population survey. Employee Benefit Research Institute (EBRI) Issue Brief. Available https://www.ebri.org/content/sources-of-health-insurance-and-characteristics-of-the-uninsured-analysis-of-the-march-2013-current-population-survey-5272.

  15. Hargraves, J. L., & Hadley, J. (2003). The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Services Research, 38(3), 809–829.

    PubMed  PubMed Central  Google Scholar 

  16. Durden, T. E., & Hummer, R. A. (2006). Access to healthcare among working-aged Hispanic adults in the United States. Social Science Quarterly, 87(5), 1319–1343.

    Google Scholar 

  17. Ginzberg, E. (1991). Access to health care for Hispanics. Journal of the American Medical Association, 265(2), 238–241.

    CAS  PubMed  Google Scholar 

  18. Flores, A., Lopez, G., & Radford, J. (2017). Facts on US Latinos, 2015: Statistical portrait of Hispanics in the US. Pew Research Center: Hispanic Trends. Retrieved September 18, 2017 from www.pewhispanic.org/2017/09/18/facts-on-u-s-latinos-current-data/.

  19. Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014). Mirror, mirror on the wall, 2014 update: How the U.S. health care system compares internationally. New York: The Commonwealth Fund.

    Google Scholar 

  20. Squires, D., & Anderson, C. (2015). U.S. health care from a global perspective: Spending, use of services, prices, and health in 13 countries (Vol. 1819). New York: The Commonwealth Fund.

    Google Scholar 

  21. Cohen, R. A., Martinez, M. E., & Zammitti, E. P. (2016). Health insurance coverage: Early release of estimates from the National Health Interview Survey, January–March 2016. U.S. Department of Health and Human Services - Centers for Disease Control and Prevention - National Center for Health Statistics. Available https://www.cdc.gov/nchs/data/nhis/earlyrelease/Insur201808.pdf.

  22. OECD. (2011). Measuring health coverage. Measuring health coverage. Retrieved August 2, 2017 from http://www.oecd.org/els/health-systems/measuring-health-coverage.htm.

  23. Brown, E. R., Wyn, R., & Teleki, S. (2000). Disparities in health insurance and access to care for residents across US cities. University of California Los Angeles (UCLA) Center for Health Policy Research. Available https://collections.nlm.nih.gov/catalog/nlm:nlmuid-100964681-pdf.

  24. Callahan, S. T., & Cooper, W. O. (2005). Uninsurance and health care access among young adults in the United States. Pediatrics, 116(1), 88–95.

    PubMed  Google Scholar 

  25. Callahan, S. T., Hickson, G. B., & Cooper, W. O. (2006). Health care access of Hispanic young adults in the United States. Journal of Adolescent Health, 39(5), 627–633.

    PubMed  Google Scholar 

  26. Carrasquillo, O., Carrasquillo, A. I., & Shea, S. (2000). Health insurance coverage of immigrants living in the United States: Differences by citizenship status and country of origin. American Journal of Public Health, 90(6), 917–923.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Grieco, E. (2004). Health insurance coverage of the foreign born in the United States: Numbers and trends. Migration Policy Institute (MPI). Available https://www.migrationpolicy.org/research/health-insurance-coverage-foreign-born-united-states-numbers-and-trends.

  28. Hubbell, F. A., Waitzkin, H., Mishra, S. I., Dombrink, J., & Chavez, L. R. (1991). Access to medical care for documented and undocumented Latinos in a southern California county. Western Journal of Medicine, 154(4), 414–417.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Ku, L., & Matani, S. (2001). Left out: Immigrants’ access to health care and insurance. Health Affairs (Millwood), 20(1), 247–256.

    CAS  Google Scholar 

  30. Schoen, C., & DesRoches, C. (2000). Uninsured and unstably insured: The importance of continuous insurance coverage. Health Services Research, 35(1), 187–206.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Freeman, G., & Lethbridge-Cejku, M. (2006). Access to health care among Hispanic or Latino women: United States, 2000-2002. Advance Data, 368, 1–25.

    Google Scholar 

  32. United States Congress. (2015). The economic state of the Latino community in America. Washington, D.C.: Joint Economic Committee.

    Google Scholar 

  33. Schur, C. L., Feldman, J. J., & Fund C. (2001). Running in place (Vol. 453). New York: The Commonwealth Fund.

    Google Scholar 

  34. Stevens, J., & Artiga, S. (2013). Key facts on health coverage for low-income immigrants today and under the Affordable Care Act. The Henry J: Kaiser Family Foundation.

    Google Scholar 

  35. Durden, T. E., & Dean, L. G. (2013). Health insurance coverage of Hispanic adults: An assessment of subgroup difference and the impact of immigration. The Social Science Journal, 50(4), 658–664.

    Google Scholar 

  36. Echeverria, S. E., & Carrasquillo, O. (2006). The roles of citizenship status, acculturation, and health insurance in breast and cervical cancer screening among immigrant women. Medical Care, 44(8), 788–792.

    PubMed  Google Scholar 

  37. Schur, C. L., Albers, L. A., & Berk, M. L. (1995). Health care use by Hispanic adults: Financial vs. non-financial determinants. Health Care Financing Review, 17(2), 71–88.

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Solis, J., Marks, G., Garcia, M., & Shelton, M. (1990). Acculturation, access to care, and use of preventive services by Hispanics: Findings from HHANES 1982-84. American Journal of Public Health, 80, 11–19.

    PubMed  PubMed Central  Google Scholar 

  39. Kamimura, A., Christensen, N., Tabler, J., Ashby, J., & Olson, L. M. (2013). Patients utilizing a free clinic: Physical and mental health, health literacy, and social support. Journal of Community Health, 38(4), 716–723.

    PubMed  Google Scholar 

  40. Katz, V. S., Ang, A., & Suro, R. (2012). An ecological perspective on US Latinos’ health communication behaviors, access, and outcomes. Hispanic Journal of Behavioral Sciences, 34(3), 437–456.

    Google Scholar 

  41. Maxwell, J., Cortes, D. E., Schneider, K. L., Graves, A., & Rosman, B. (2011). Massachusetts’ health care reform increased access to care for Hispanics, but disparities remain. Health Affairs (Millwood), 30(8), 1451–1460.

    Google Scholar 

  42. Wilkin, H. A., & Ball-Rokeach, S. J. (2011). Hard-to-reach? Using health access status as a way to more effectively target segments of the Latino audience. Health Education Research, 26(2), 239–253.

    PubMed  Google Scholar 

  43. Berry, J. W. (2005). Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations, 29(6), 697–712.

    Google Scholar 

  44. Dembe, A. E., Biehl, J. M., Smith, A. D., & de Gutierrez, T. G. (2013). Employers’ role in helping Latino workers obtain access to health care services: Results of a community-based pilot demonstration project. Journal of Immigrant and Minority Health, 15(3), 661–665.

    PubMed  Google Scholar 

  45. Fukuyama, F. (1999). Social capital and civil society. In IMF conference on second generation reforms, Washington, DC.

  46. Keeley, B. (2007). Human capital: How what you know shapes your life. Paris: Organisation for Economic Cooperation and Development (OECD).

    Google Scholar 

  47. Granovetter, M. (1985). Economic action and social structure: The problem of embededdness. American Journal of Sociology, 91(3), 481–510.

    Google Scholar 

  48. Lin, N. (2001). Building a network theory of social capital. In N. Lin, K. Cook, & R. S. Burt (Eds.), social capital (pp. 3–30). New York: Aldine De Gruyter.

    Google Scholar 

  49. Coleman, J. S. (1988). Social capital in the creation of human capital. American Journal of Sociology, 94, s95–s120.

    Google Scholar 

  50. Bourdieu, P. (1986). The forms of capital. In J. G. Richardson (Ed.), Handbook of theory and research for the sociology of education. New York: Greenwood.

    Google Scholar 

  51. Bourdieu, P. (2011). The forms of capital. In I. Szeman & T. Kaposy (Eds.), Cultural theory: An anthology (1st ed., pp. 83–95). West Sussex: John Wiley & Sons.

    Google Scholar 

  52. Putnam, R. D. (1995). Bowling alone: America’s declining social capital. Journal of Democracy, 6(1), 65–78.

    Google Scholar 

  53. Putnam, R. D. (1993). The prosperous community. The American Prospect, 4(13), 35–42.

    Google Scholar 

  54. Woolcock, M. (1998). Social capital and economic development: Toward a theoretical synthesis and policy framework. Theory and Society, 27(2), 151–208.

    Google Scholar 

  55. Woolcock, M. (2001). The place of social capital in understanding social and economic outcomes. Canadian Journal of Public Policy, 2, 11–17.

    Google Scholar 

  56. Perez-Escamilla, R. (2010). Health care access among Latinos: Implications for social and health care reforms. Journal of Hispanic Higher Education, 9(1), 43–60.

    Google Scholar 

  57. Torres, E., Erwin, D. O., Trevino, M., & Jandorf, L. (2013). Understanding factors influencing Latina women’s screening behavior: A qualitative approach. Health Education Research, 28(5), 772–783.

    PubMed  Google Scholar 

  58. Bushman, B. J., & Wang, M. C. (2009). Vote counting procedures in meta-analyses. In H. Cooper, L. V. Hedges, & J. C. Valentine (Eds.), The handbook of research synthesis and meta-analysis (pp. 207–220). New York: Russell Sage Foundation.

    Google Scholar 

  59. Qin, H., & Grigsby, M. (2016). A systematic review and ‘meta-study’ of meta-analytical approaches to the human dimensions of environmental change. Human Ecology Review, 22(2), 109–136.

    Google Scholar 

  60. Escobedo, L. G., & Cardenas, V. M. (2006). Utilization and purchase of medical care services in Mexico by residents in the United States of America, 1998-1999. Revista Panamericana de Salud Pública, 19(5), 300–305.

    PubMed  Google Scholar 

  61. Jadav, S., Rajan, S. S., Abughosh, S., & Sansgiry, S. S. (2015). The role of socioeconomic status and health care access in breast cancer screening compliance among Hispanics. Journal of Public Health Management & Practice, 21(5), 467–476.

    Google Scholar 

  62. Talavera-Garza, L., Ghaddar, S., Valerio, M., & Garcia, C. (2013). Health care access and utilization among Hispanic manufacturing workers along the Texas-Mexico border. Journal of Health Care for the Poor and Underserved, 24(2), 656–670.

    PubMed  Google Scholar 

  63. Torres, M., Parra-Medina, D., & Johnson, A. O. (2008). Rural hospitals and Spanish-speaking patients with limited English proficiency. Journal of Healthcare Management, 53(2), 107–120.

    PubMed  Google Scholar 

  64. Padilla, Y. C., Scott, J. L., & Lopez, O. (2014). Economic insecurity and access to the social safety net among Latino farmworker families. Social Work, 59(2), 157–165.

    PubMed  Google Scholar 

  65. Valenzuela, J. M., McDowell, T., Cencula, L., Hoyt, L., & Mitchell, M. (2013). Hazlo bien! A participatory needs assessment and recommendations for health promotion in growing Latino communities. American Journal of Health Promotion, 27(5), 339–346.

    PubMed  Google Scholar 

  66. Stone, L. C., Boursaw, B., Bettez, S. P., Larzelere Marley, T., & Waitzkin, H. (2015). Place as a predictor of health insurance coverage: A multivariate analysis of counties in the United States. Health Place, 34, 207–214.

    PubMed  PubMed Central  Google Scholar 

  67. Quinn, K., et al. (2000). Working without benefits: The health insurance crisis confronting Hispanic Americans. The Commonwealth Fund, Task Force on the Future of Health Insurance for Working Americans. Available https://www.commonwealthfund.org/publications/fund-reports/2000/mar/working-without-benefits-health-insurance-crisis-confronting.

  68. Vitullo, M. W., & Taylor, A. K. (2002). Latino adults’ health insurance coverage: An examination of Mexican and Puerto Rican subgroup differences. Journal of Health Care for the Poor and Underserved, 13(4), 504–525.

    PubMed  Google Scholar 

  69. Portes, A. (1995). Economic sociology and the sociology of immigration: A conceptual overview. In A. Portes (Ed.), Economic sociology of immigration (pp. 1–41). New York: Russell Sage Foundation.

    Google Scholar 

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Authors and Affiliations

  1. Extension Professional in Community Development, University of Missouri, 302 S. Main, Courthouse Basement, Carthage, MO, 64836, USA

    Maria E. Rodriguez-Alcalá

  2. Division of Applied Social Sciences, University of Missouri, 228 Gentry Hall, Columbia, MO, 65211, USA

    Hua Qin

  3. Division of Applied Social Sciences, Extension Community Development Director, Cambio Center Director, University of Missouri, 229 Gentry Hall, Columbia, MO, 65211, USA

    Stephen Jeanetta

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  1. Maria E. Rodriguez-Alcalá
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  2. Hua Qin
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Appendix

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Table 6 List of articles included in the meta-study
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Rodriguez-Alcalá, M.E., Qin, H. & Jeanetta, S. The Role of Acculturation and Social Capital in Access to Health Care: A Meta-study on Hispanics in the US. J Community Health 44, 1224–1252 (2019). https://doi.org/10.1007/s10900-019-00692-z

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