Influence of education, socioeconomic status, insurance status and acculturation on the functional status of Latino primary care patients

Although significant attention has been paid to improving healthcare access for Latinos, less is known about the factors that predict health status among Latinos who do access care. We evaluated sociodemographic, insurance and acculturation variables among 264 Latino adult primary care patients randomly selected from 16 different clinic sites in Southern California over a 7-month period in 1999. 93% of eligible patients agreed to participate. The SF-36 was used to assess functional status. About half of patients had less than a high school education (44.7%) and made less than $40,000 per year (73.7%). 30.3% of patients received Medi-Cal or Medicare, and 84.3% had low or medium acculturation level. Education, annual household income, type of insurance used to pay for clinic visit, and acculturation were all significantly associated with individual functional status measures (p < 0.05). In multivariate analyses, education level, paying for the clinic visit with Medi-Cal or Medicare benefits and acculturation remained independent predictors of general health perception (p < 0.001). Latinos with high acculturation levels had greater mean scores on a 100-point scale representing general health perception (70.83, s.d.= 19.99) than those with medium (68.71, s.d. = 32.03) or low (55.23, s.d. = 21.45) acculturation level. Educational level, SES, insurance status and acculturation remain significant predictors of general health for Latinos who are able to access primary care services. Consistent with previous research, acculturation level was positively associated with self-perception of health in the present study. Implications of findings for primary care service planning and delivery are discussed.