Place of residence, acculturation, and the use of preventive services among Hispanic subgroups

Study Objective: To explore the use of preventive health services by Hispanic subgroup and its relationship to acculturation and place of residence (rural v. urban).

Data Source: Data from the 1998-2000 National Health Interview Survey (NHIS) were used (92,418 persons; 8,799 Mexican-Americans, 1,659 Puerto Ricans, 947 Cuban-Americans, 4,151 “other” Hispanics, 63,731 non-Hispanic Whites, and 13,131 non-Hispanic Blacks).

Methods: Descriptive analyses characterize preventive service utilization patterns by race and ethnicity. Multiple logistic regression was used to calculate adjusted odds ratios (OR). All analyses were performed to reflect the complex NHIS sampling frame. Acculturation analyses were restricted to the Hispanic/Latino subgroups.

Results: The Hispanic subgroup sample reported varying levels of acculturation: Puerto Ricans were the most acculturated (44%) and Cubans the least (15%). Low acculturated Hispanics are less likely to have a usual source of care (OR=0.59; CI=0.50, 0.70). Rural Hispanics reported lower use of preventive services and were more uninsured than urban Hispanics. Uninsured Hispanics were less likely to report a usual source of care (OR=0.68; CI=0.50, 0.93).

Conclusion: Study results highlight an opportunity to tailor appropriate outreach and educational programs that promote the use of preventive health services by Hispanics, especially those in rural areas. The lack of preventive services use coupled with no usual source of care demand policies that facilitate access to the health care system. Our results also support the need for further research on Hispanic subgroups, given the mixed findings of preventive health services needs by specific subgroups and varying levels of acculturation.