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Children with Special Health Care Needs: How Immigrant Status is Related to Health Care Access, Health Care Utilization, and Health Status

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Abstract

To compare health care access, utilization, and perceived health status for children with SHCN in immigrant and nonimmigrant families. This cross-sectional study used data from the 2003 California Health Interview Survey to identify 1404 children (ages 0–11) with a special health care need. Chi-square and logistic regression analyses were used to examine relations between immigrant status and health access, utilization, and health status variables. Compared to children with special health care needs (CSHCN) in nonimmigrant families, CSHCN in immigrant families are more likely to be uninsured (10.4 vs. 4.8%), lack a usual source of care (5.9 vs. 1.9%), report a delay in medical care (13.0 vs. 8.1%), and report no visit to the doctor in the past year (6.8 vs. 2.6%). They are less likely to report an emergency room visit in the past year (30.0 vs. 44.0%), yet more likely to report fair or poor perceived health status (33.0 vs. 16.0%). Multivariate analyses suggested that the bivariate findings for children with SHCN in immigrant families largely reflected differences in family socioeconomic status, parent’s language, parental education, ethnicity, and children’s insurance status. Limited resources, non-English language, and limited health-care use are some of the barriers to staying healthy for CSHCN in immigrant families. Public policies that improve access to existing insurance programs and provide culturally and linguistically appropriate care will likely decrease health and health care disparities for this population.

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Acknowledgements

Funding for this study was provided by the Academic Pediatrics Association Young Investigators Grant Program, Children’s Health Initiative Pediatric Research Grant (Lucile Packard Foundation for Children’s Health), The William Randolph Hearst Foundation, and the Department of Pediatrics at Childrens Hospital Los Angeles. The authors thank Maureen Lahiff, PhD, for statistical consultation and programming support.

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Authors and Affiliations

  1. Division of General Pediatrics, Childrens Hospital Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #76, Los Angeles, CA, 90027, USA

    Joyce R. Javier

  2. Division of General Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA

    Lynne C. Huffman & Fernando S. Mendoza

  3. Division of General Pediatrics, Center for Health Policy/Primary Care and Outcomes Research, Stanford University School of Medicine, Palo Alto, CA, USA

    Paul H. Wise

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  1. Joyce R. Javier
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  2. Lynne C. Huffman
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  3. Fernando S. Mendoza
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  4. Paul H. Wise
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Corresponding author

Correspondence to Joyce R. Javier.

Appendix

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Table 6 Definition of study sample based on CSHCN screener and corresponding CHIS question
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Javier, J.R., Huffman, L.C., Mendoza, F.S. et al. Children with Special Health Care Needs: How Immigrant Status is Related to Health Care Access, Health Care Utilization, and Health Status. Matern Child Health J 14, 567–579 (2010). https://doi.org/10.1007/s10995-009-0487-9

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  • DOI: https://doi.org/10.1007/s10995-009-0487-9

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