Undocumented immigrants' health status and health care utilization: Findings from the California Health Interview Survey

Background: Unfounded claims that the undocumented are sicker and use more healthcare encouraged political support for excluding them from receiving health insurance coverage or purchasing it in the exchange under the Affordable Care Act (ACA).

Objectives: To analyze health status and utilization of undocumented migrants compared with citizens in the United States.

Methods: We used data from the 2009 California Health Interview Survey (n=47,397) and applied descriptive and multivariate logistic regression analyses.

Results: Compared to US-born citizens, the undocumented were more likely to report fair or poor health and be overweight or obese but less likely to have asthma. However, undocumented did not differ in rates of heart disease, diabetes or smoking. The undocumented were significantly less likely to have an ER visit or to have visited a doctor last year compared to US-born citizens in unadjusted models. Among those who had visited the doctor last year, the undocumented were significantly less likely to have had 5 or more visits. In adjusted multivariate analyses, the descriptive results were sustained except that no difference was found between undocumented and US-born citizens in visiting a doctor last year.

Conclusions: These data contradict perceptions that undocumented migrants are sicker and use more health services. Permitting the lower risk undocumented to obtain health insurance through health benefit exchanges may improve the availability of lower premiums as well as help maintain the lower risk status of this population. Excluding the undocumented population may adversely impact overall population health.