Online Program

Social determinants of physician care utilization vary by generational status for Mexican-identified Californians

Monday, November 2, 2015

Mariaelena Gonzalez, Ph.D., Public Health, University of California Merced, Merced, CA
Jennifer Mendiola, M.A., Department of Psychological Sciences, University of California, Merced, Merced, CA
Anna V. Song, PhD, Psychological Sciences, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA
Lillian Diaz Rios, PhD, University of California Cooperative Extension - Merced, Merced, CA
Mary V. Modayil, MSPH, PhD, California Department of Public Health, California Tobacco Control Program, Sacramento, CA
Background: Previous research shows Hispanics are less likely to report a usual health care provider, which combined with high prevalence of overweight/obese, heightens risk for chronic diseases. A health in all policies approach requires understanding generational  differences in Latino health care utilization. In California, fewer foreign born Latinos have health insurance coverage(23% vs 36%)  or have visited a physician (73% vs 78%) compared to US born Latinos. We examined behavioral and social factors including access to care that predict these generational differences in medical care utilization..

Methods:  We explored risk factors among first, second, and third generational status Mexican-identified respondents from the 2011-12 California Health Interview Survey (N=7,466) using a logistic regression analysis. Predictor variables included smoking status, binge drinking, insurance status, self-rated health, social capital, obesity and other demographic variables. We then stratified the sample by nativity (US born: N=3,142; foreign-born: N=4,324), re-running the analysis for each subsample.

Results: Second generation individuals had higher odds of visiting a physician than first generation individuals (OR=1.36, p=0.009). Smoking, civic engagement, and being in good health were associated with decreased odds of visiting a physician. After stratifying our sample by nativity, several variables remained a salient predictor for US born Latinos, but not foreign-born Latinos: smoking, civic engagement, and being 60 or older. 

Conclusion:  Policy interventions to increase health care utilization among Latinos should consider generational differences in behavioral and social factors. Our findings supports the assertion that smoking plays a role in health differences between US and foreign born Latinos.

Learning Areas:

Diversity and culture
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Identify and compare the differences in medical service utilization among Mexican-identified Californians. Discuss why generational status is important to understanding the social determinants of physician visits within the Hispanic community. Explain why smoking may significantly contribute to the healthy immigrant paradox among Latinos.

Keyword(s): Health Care Access, Latinos

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am graduate student in the health psychology grogram at the University of California, Merced. I have worked under the direction of Anna Song, PhD and Mariaelena Gonzalez, PhD. Together we have examined several social determinants of risk and prevention behaviors among Mexican-identified Californians
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.