Abstract
Mexican Americans are more likely to experience barriers to access and utilization of healthcare services than any other U.S. Hispanic group. In Mexico, where the majority of the population has access to care, the pressing issue is the underutilization of preventive services among adults. This study was conducted to assess access and utilization barriers among a U.S.-Mexico border population. A cross-sectional, population-based survey was conducted during 1999–2000 in a pair of contiguous U.S.-Mexico border communities. Household surveys were administered to U.S. and Mexican women, 40 years of age and older, to assess healthcare access and utilization, participation in chronic disease screenings, orientation toward prevention and personal history of chronic disease. Analysis indicates few statistically significant differences (p < 0.05) among access and utilization variables by country. Mexican participants were more likely to have a regular source of care and to have had a blood sugar test within the past 12 months. U.S. participants more often reported having had a Pap smear and mammogram during the previous year. Factors independently positively associated with having had a routine check-up during the past 12 months included age and having a regular provider or place to go when sick. Only going to the doctor when ill was independently inversely associated with routine check-ups in the past 12 months. Findings suggest that U.S. and Mexican border populations are similar with regard to healthcare access and utilization characteristics. Efforts to increase utilization of preventive health screenings among women are needed at the U.S.-Mexico border.
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REFERENCES
U.S. Census Bureau. Available at: http://www.census.gov.
Council on Scientific Affairs. Hispanic health in the United States. JAMA 1991; 265:248–252.
Solis JM, Marks G, Garcia M, Shelton D. Acculturation, access to care, and use of preventive services by Hispanics: Findings from HHANES 1982–84. Am J Public Health 1990; 80(suppl): 11–19.
Treviño FM, Moyer ME, Burciaga Valdez R, Stroup-Benham CA. Health insurance coverage and utilization of health services by Mexican Americans, mainland Puerto Ricans, and Cuban Americans. JAMA 1991; 265:233–237.
Centers for Disease Control and Prevention. Health insurance coverage and receipt of preventive health services: United States, 1993. MMWR Morb Mortal Wkly Rep 1995; 44:219–225.
Hafner-Eaton C. Physician utilization disparities between the uninsured and insured. JAMA 1993; 269:787–792.
Ayanian JZ, Weissman JS, Schneider EC, Ginsburg JA, Zaslavsky AM. Unmet health needs of uninsured adults in the United States. JAMA 2000; 284:2061–2069.
U.S. Department of Health and Human Services. United States-Mexico Border Health Commission Annual Report. El Paso: United States-Mexico Border Health Commission Office; 2001; 5–7 and 22–25.
Secretaría de Salud (Mexico). El Plan de Acción de la Diabetes Mellitus. Mexico, D.F.: Secretaría de Salud; 2002.
Ornelas K. El gasto público en salud en Sonora: análisis del gasto de los programas de atención curativa y atención preventiva de la Secretaría de Salud Pública en el período 1992–2002 [Masters Thesis]. Hermosillo, Sonora, Mexico: El Colegio de Sonora; Fall 2002.
Frenk J, Gómez-Dantés O, Cruz C, Chacón F, Hernández P, Freeman P. Consequences of the North American Free Trade Agreement for health services: a perspective from Mexico. Am J Public Health 1994; 84:1591–1597.
Homedes N, Chacón-Sosa F, Nichols A, Otálora-Soler M, LaBrec P, Alonso-Vázquez L. Utilization of health services along the Arizona-Sonora border: the providers' perspective. Salud Publica Mex 1994; 36:633–645.
Homedes N, Guernsey de Zapien J, Denman C, et al. From division to coalition: building bridges across the Arizona-Sonora border. Border Health/Salud Fronteriza 1992; 8:23–31.
Guendelman S, Jasis M. Measuring Tijuana residents' choice of Mexican or U.S. health care services. Public Health Rep 1990; 105:575–583.
Denman C, Guernsey de Zapien J, Haro JA, et al. Perinatal care in both Nogales: a need for binational cooperation. Border Health/Salud Fronteriza 1992; 8:32–40.
Zaragoza X. Immigration reform groups meet May 13. The Daily Dispatch 2000 May 5; pp 1–2.
Zaragoza X. Supervisors told INS is working toward control of Douglas, border area. The Daily Dispatch 2000 May 12; pp 1, 3.
Associated Press. Mexican officials preparing to sue ranchers in U.S. The Daily Dispatch 2000 May 4; pp 1, 3.
Zaragoza X. More Border Patrol agents, more fence, more lights coming to Douglas. The Daily Dispatch 2000 May 13; pp 1, 3.
U.S. Department of Health and Human Services. The 2000 HHS Poverty Guidelines Web site. Available at: http://aspe.os.dhhs.gov/poverty/00poverty.htm.
Uriarte A. Acuden más de mil a "Oportunidades". El Imparcial 2002 April 24. Available at: http://www.elimparcial.com/edicionimpresa/traernota.asp?NumNota=209089.
El Colegio de Sonora. Banco Regional de Consulta Website. Available at: http://www.colson.edu. mx/barco/.
American Cancer Society. Cancer Prevention and Early Detection: Facts and Figures 2002. Atlanta: American Cancer Society; 2002.
Sankaranarayanan R, Budukh AM, Rajkumar R. Effective screening programmes for cervical cancer in low-and middle-income developing countries. Bull World Health Organ 2001; 79:954–962.
Olaiz G, Hernandez M. EsCancer, un encuentro con el futuro epidemiologico. In: Sepulveda J, editor. Los retos de la transicion. Los Cuadernos de Salud, Number 1. Mexico, D.F.: Secretaría de Salud; 1994. p. 81.
Andersen R, Zelman Lewis S, Giachello AL, Aday LA, Chiu G. Access to medical care among the Hispanic population of the southwestern United States. J Health Soc Behav 1981; 22:78–89.
Estrada AL, Treviño FM, Ray LA. Health care utilization barriers among Mexican Americans: Evidence from HHANES 1982–84. Am J Public Health 1990; 80:27–31.
Treviño RP, Treviño FM, Medina R, Ramirez G, Ramirez RR. Health care access among Mexican Americans with different health insurance coverage. J Health Care Poor Underserved 1996; 7:112–121.
Parchman M, Byrd T. Access to and use of ambulatory health care by a vulnerable Mexican American population on the U.S.-Mexico border. J Health Care Poor Underserved 2001; 12:404–414.
Secretaría de Salud (Mexico). Encuesta Nacional de Salud II (ENSA 2000). Mexico, D.F.: Secretaría de Salud; 2002.
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Hunter, J.B., de Zapien, J.G., Denman, C.A. et al. Healthcare Access and Utilization Among Women 40 and Older at the U.S.-Mexico Border: Predictors of a Routine Check-Up. Journal of Community Health 28, 317–333 (2003). https://doi.org/10.1023/A:1025440528845
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DOI: https://doi.org/10.1023/A:1025440528845