Longitudinal Changes in Access to Usual Source of Care among Recently-Arrived Older Foreign-Born Individuals

Among recently-arrived older immigrants, the sign of systemic inaccessibility to health care is observed. Based on the previous literature, this study hypothesizes that compared to longer-term immigrants and the U.S.-born, recently arrived older immigrants are less likely to have a usual source of care over time because of their lower rates of health insurance (mediating effects). Using three waves of data from the Second Longitudinal Study of Aging (1994-2000), this study compares the longitudinal trajectories of having a usual source of care (yes/no) between three groups (age 70+)- 1) late-life immigrants with less than 15 years of residence in US (recent immigrants; n=133); 2) longer-term immigrants (15 years or longer in US; n=672); and 3) the U.S.-born (n=8,642). A series of hierarchical generalized linear models (HGLM) were run to test the mediating relationship longitudinally. The adapted Andersen model guided the overall analysis. The results indicate that although the probabilities of having a usual source of care increased over time across all three groups, recent immigrants were less likely to have Medicare and private insurance over time. Their lower probabilities of having private insurance/Medicare, in turn, were related to lower probabilities of having a usual source of care over time. There was no direct relationship between immigrant status and having a usual source of care. To prevent the use of more expensive forms of care in the long run, policy efforts should be made to expand late-life immigrants' health insurance coverage by increasing affordable health insurance options for this population.