Location, Location, Location: State and Community Contexts That Improve Health Care Access for Children of Mexican Immigrants

Deborah Roempke Graefe, Pennsylvania State University
Gordon F. De Jong, Pennsylvania State University
Stephanie Howe, Pennsylvania State University

Area contextual inequalities in immigrant health care access are salient to public policy debates on immigration and health. We examine the contextual effects of state health insurance eligibility policy, local community health clinic availability, local health system language translation services, and residence in new vs. traditional immigrant destinations on regular physician care for children of Mexican immigrants. Originally-collected data on state Child Health Insurance Program (CHIP) eligibility policies for immigrant children and county-level data on health clinic availability and language translation services -- identified as front-line institutional services for immigrant health needs -- are integrated with individual-level, nationally representative data from the 1996-1999 and 2001-2003 panels of the Survey of Income and Program Participation. Utilizing multi-level regression, the results document persistent contextual factors as well as child and parent mediating attributes that help identify those most at-risk of “falling between the cracks” with no regular physician care.