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  • Title: Longitudinal changes in access to health care by immigrant status among older adults: the importance of health insurance as a mediator.
    Author: Choi S.
    Journal: Gerontologist; 2011 Apr; 51(2):156-69. PubMed ID: 20693237.
    Abstract:
    PURPOSE: This longitudinal study examined the role of health insurance in access to health care among older immigrants. DESIGN AND METHODS: Using data from the Second Longitudinal Study of Aging, the longitudinal trajectories of having a usual source of care were compared between 3 groups (all 70+ years): (a) late-life immigrants with less than 15 years of residence in the United States ("recent immigrants"; n = 133), (b) "earlier immigrants" (15 years or longer in the United States, n = 672), and (c) U.S. born (n = 8,642). A series of hierarchical generalized linear models were run to test the mediating relationship of health insurance between immigrant status and having a usual source of care. RESULTS: 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; this in turn was related to lower probabilities of having a usual source of care (indirect relationship). There was no direct relationship between immigrant status and having a usual source of care. IMPLICATIONS: To prevent the use of more expensive forms of care in the long run, policy efforts should expand late-life immigrants' health insurance coverage by increasing affordable health insurance options.
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