Skip to main content
SpringerLink
Log in

Health Care Satisfaction: Effects of Immigration, Acculturation, Language

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

Abstract

Differences in health care satisfaction can alter patterns of health care utilization and so affect health outcomes, but little is known about variation in satisfaction in relation to immigration status. Health care satisfaction is analyzed with survey data from state public health program patients. Overall health care satisfaction is higher for first generation Hispanic immigrants and lower among those in the second generation compared to white Americans—consistent with the pattern termed the “healthy migrant effect.” This pattern is more pronounced for Portuguese-speaking immigrants and is not explained by self-reported health, communication ability or acculturation. Satisfaction with specific aspects of health care follows different patterns that may be explained by differences in experiences and culture. As anticipated by segmented assimilation theory, we find variation in cross-generational patterns of health care satisfaction both within and between ethnic groups. This variation indicates the importance of distinguishing Portuguese-speakers from Spanish-speakers and of taking into account differences in the ways they are able to communicate with health care providers as well as differences in their orientations toward health care. Our disparate findings with other immigrant groups also reinforce limiting expectations of a “healthy migrant effect” to Latinos. Finally, the variable influences on different satisfaction measures indicate the importance of considering the relative influence of culturally-based orientations and health care experiences on the specific outcomes measured, with particular sensitivity to acceptance of individualized standards of care.

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.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abraido-Lanza A, Armbrister AN, Flórez KR, Aguirre AN. Toward a theory-driven model of acculturation in public health research. Am J Public Health. 2006;96:1342–6.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Acevedo-Garcia D, Bates LM. Latino health paradoxes: empirical evidence, explanations, future research, and implications. In: Rodriguez H, Saenz R, Menjivar C, editors. Latinos/as in the United States: changing the face of America. New York: Springer; 2008. p. 101–13.

    Chapter  Google Scholar 

  3. Aharony L, Stasser S. Patient satisfaction: what we know about and what we still need to explore. Med Care Rev. 1993;50(1):49–79.

    Article  CAS  PubMed  Google Scholar 

  4. Anderson B. The benefits to nurse-led telephone follow-up for prostate cancer. Br J Nurs. 2010;19(17):1085–90.

    Article  PubMed  Google Scholar 

  5. Arcia E, Skinner M, Bailey D, Correa V. Models of acculturation and health behaviors among Latino immigrants to the US. Soc Sci Med. 2001;53:41–53.

    Article  CAS  PubMed  Google Scholar 

  6. Bakker D, Lightfoot N, Steggles S, Jackson C. The experience and satisfaction of women attending breast cancer screening. Oncol Nurs Forum. 1998;25(1):115–21.

    CAS  PubMed  Google Scholar 

  7. Borders TF, Warner RD, Sutkin G. Satisfaction with health care and cancer screening practices among women in a largely rural region of west Texas. Prev Med. 2003;36(6):652–8.

    Article  PubMed  Google Scholar 

  8. Bredart A, Bouleuc D, Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol. 2005;17(4):351–4.

    Article  PubMed  Google Scholar 

  9. Brown J, Boles M, Mullooly JP, Levinson WP. Effect of clinician communication skills training on patient satisfaction. Ann Intern Med. 1999;131(11):822–9.

    Article  CAS  PubMed  Google Scholar 

  10. Bzostek S, Goldman N, Pebley A. Why do Hispanics in the USA report poor health? Soc Sci Med. 2007;64:990–1003.

    Article  Google Scholar 

  11. Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality care. Inquiry. 1988;25(1):25–36.

    CAS  PubMed  Google Scholar 

  12. Foxall MJ, Barron CR, Houfek J. Women’s satisfaction with breast and gynecological cancer screening. Women Health. 2003;38(1):21–36.

    Article  PubMed  Google Scholar 

  13. Gonzalez-Castro F, Marsiglia FF, Kulis S, Kellison JG. Lifetime segmented assimilation trajectories and health outcomes in Latino and other community residents. Am J Public Health Res Pract. 2010;100(4):669–76.

    Article  Google Scholar 

  14. Hall JA, Dornan MC. Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. Soc Sci Med. 1988;27(6):637–44.

    Article  CAS  PubMed  Google Scholar 

  15. Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med. 1990;7:811–8.

    Article  Google Scholar 

  16. Harris LE, Luft FC, Rudy DW, Tierney WM. Correlates of health care satisfaction in inner-city patients with hypertension and chronic renal insufficiency. Soc Sci Med. 1995;41:1639–45.

    Article  CAS  PubMed  Google Scholar 

  17. Haviland MG, Morales LS, Dial TH, Pincus HA. Race/ethnicity, socioeconomic status, and satisfaction with health care. Am J Med Qual. 2005;20:195–203.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Hawley S, Janz N, Lillie S, Friese C, Griggs J, Graff J. Perceptions of care coordination in a population-based sample of diverse breast cancer patients. Patient Educ Couns. 2010;81(Suppl):S34–40.

    Article  PubMed  Google Scholar 

  19. Hekkert KD, Cihangir S, Kleefstra SM, van den Berg B, Kool RB. Patient satisfaction revisited: a multilevel approach. Soc Sci Med. 2009;69:68–75.

    Article  PubMed  Google Scholar 

  20. Jackson J, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med. 2001;52(4):609–20.

    Article  CAS  PubMed  Google Scholar 

  21. Linder-Pelz S. Toward a theory of patient satisfaction. Soc Sci Med. 1982;16:577–82.

    Article  CAS  PubMed  Google Scholar 

  22. Mirowsky J, Ross CE. Patient satisfaction and visiting the doctor: a self-regulating system. Soc Sci Med. 1983;17(18):1353–61.

    Article  CAS  PubMed  Google Scholar 

  23. Morales L, Cunningham W, Brown J, Liu H, Hays R. Are Latinos less satisfied with communication by health care providers? J Gen Intern Med. 1999;14:409–17.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Park J, Myers D, Kao D, Min SH. Immigrant obesity and unhealthy assimilation: alternative estimates of convergence or divergence, 1995–2005. Soc Sci Med. 2009;69:1625–33.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plan. 1983;6(3–4):291–7.

    Google Scholar 

  26. Portes A, Zhou M. The new second generation: segmented assimilation and its variants among post-1965 immigrant youth. Ann Am Acad Pol Soc Sci. 1993;530:74–98.

    Article  Google Scholar 

  27. Roberts RE, Attkisson CC. Assessing client satisfaction among Hispanics. Eval Program Plan. 1983;6:401–13.

    Article  CAS  Google Scholar 

  28. Roman A, Bolcic-Jankovic D, Mahmood R. Care coordination program: field report, July 2012. Boston: Center for Survey Research, University of Massachusetts Boston; 2012.

    Google Scholar 

  29. Schachter A, Kimbro RT, Gorman BK. Language proficiency and health status: are bilingual immigrants healthier? J Health Soc Behav. 2012;53:124–45.

    Article  PubMed  Google Scholar 

  30. Schutt RK, Cruz ER, Woodford ML. Client satisfaction in a breast and cervical cancer early detection program: the influence of ethnicity and language, health, resources, and barriers. Women Health. 2008;48(3):283–302.

    Article  PubMed  Google Scholar 

  31. Singh GK, Siahpush M. Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases. Hum Biol. 2002;74:84–109.

    Google Scholar 

  32. Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997;45:1829–43.

    Article  CAS  PubMed  Google Scholar 

  33. Ware JE Jr, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Progam Plan. 1983;6:247–63.

    Article  Google Scholar 

  34. Waters MC, Tran VC, Kasinitz P, Mollenkopf JH. Segmented assimilation revisited: types of acculturation and socioeconomic mobility in young adulthood. Ethn Racial Stud. 2010;33:1168-93.

    Article  Google Scholar 

  35. Williams B. Patient satisfaction: A valid concept? Soc Sci Med. 1994;38:509–16.

    Article  CAS  PubMed  Google Scholar 

  36. Zastowny TR, Roghmann KJ, Cafferata GL. Patient satisfaction and the use of health services. Med Care. 1998;27:705–23.

    Article  Google Scholar 

  37. Zhou M. Segmented assimilation: issues, controversies, and recent research on the new second generation. Int Migr Rev. 1997;31:975–1008.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Funding was provided by the Massachusetts Department of Public Health (INTF3406HH2706811045). We are grateful for the collaboration of Anita Christie, RN, Mary Lou Woodford, RN, Heather Nelson, Ph.D., Jacqueline Fawcett, Ph.D., RN, FAAN, and Andrea Leverentz, Ph.D., for the assistance of Xavier Lazcano, MA, Lisa-Marie Guzman, MA, Angela Cody, MA, Jessica Callea, MA, Aliaksandra Sakhar, Margarita Alegria, Ph.D., Jorge Capetillo, Ph.D., and Donaldo Macedo, Ph.D., for survey expertise and management provided by the Center for Survey Research and Anthony Roman, MA, Dragana Bolcic-Jankovic, MA, and Rumel Mahmood, MA, and for the comments of Mathew Creighton, Ph.D. and Kathy Georgiades, Ph.D.

Author information

Authors and Affiliations

  1. Department of Sociology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA, 02125-3393, USA

    Russell K. Schutt

  2. Department of Psychiatry, Massachusetts Mental Health Center, Harvard Medical School, 75 Fenwood Rd., Boston, MA, 02215, USA

    Russell K. Schutt

  3. Grupo Nutresa, Carrera 52 # 2-38, Medellin, Colombia

    Camila Mejía

Authors
  1. Russell K. Schutt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Camila Mejía
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Russell K. Schutt.

Ethics declarations

Conflict of interest

Author Schutt has received research Grants from the Department of Public Health. Author Mejia declares that she has no conflict of interest.

Resarch involving human participants

All procedures involving human participants were reviewed and approved by the University of Massachusetts Boston’s Institutional Review Board for the Protection of Human Subjects.

Informed consent

Obtained from all individual participants through their agreement to be interviewed by phone after hearing a statement about the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schutt, R.K., Mejía, C. Health Care Satisfaction: Effects of Immigration, Acculturation, Language. J Immigrant Minority Health 19, 1372–1378 (2017). https://doi.org/10.1007/s10903-016-0409-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-016-0409-z

Keywords

Search

Navigation