IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v69y2009i10p1452-1459.html
   My bibliography  Save this article

The role of health insurance in explaining immigrant versus non-immigrant disparities in access to health care: Comparing the United States to Canada

Author

Listed:
  • Siddiqi, Arjumand
  • Zuberi, Daniyal
  • Nguyen, Quynh C.

Abstract

Using a cross-national comparative approach, we examined the influence of health insurance on U.S. immigrant versus non-immigrant disparities in access to primary health care. With data from the 2002/2003 Joint Canada/United States Survey of Health, we gathered evidence using three approaches: 1) we compared health care access among insured and uninsured immigrants and non-immigrants within the U.S.; 2) we contrasted these results with health care access disparities between immigrants and non-immigrants in Canada, a country with universal health care; and 3) we conducted a novel direct comparison of health care access among insured and uninsured U.S. immigrants with Canadian immigrants (all of whom are insured). Outcomes investigated were self-reported unmet medical needs and lack of a regular doctor. Logistic regression models controlled for age, sex, nonwhite status, marital status, education, employment, and self-rated health. In the U.S., odds of unmet medical needs of insured immigrants were similar to those of insured non-immigrants but far greater for uninsured immigrants. The effect of health insurance was even more striking for lack of regular doctor. Within Canada, disparities between immigrants and non-immigrants were similar in magnitude to disparities seen among insured Americans. For both outcomes, direct comparisons of U.S. and Canada revealed significant differences between uninsured American immigrants and Canadian immigrants, but not between insured Americans and Canadians, stratified by nativity. Findings suggest health care insurance is a critical cause of differences between immigrants and non-immigrants in access to primary care, lending robust support for the expansion of health insurance coverage in the U.S. This study also highlights the usefulness of cross-national comparisons for establishing alternative counterfactuals in studies of disparities in health and health care.

Suggested Citation

  • Siddiqi, Arjumand & Zuberi, Daniyal & Nguyen, Quynh C., 2009. "The role of health insurance in explaining immigrant versus non-immigrant disparities in access to health care: Comparing the United States to Canada," Social Science & Medicine, Elsevier, vol. 69(10), pages 1452-1459, November.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:10:p:1452-1459
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(09)00568-1
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Mohanty, S.A. & Woolhandler, S. & Himmelstein, D.U. & Pati, S. & Carrasquillo, O. & Bor, D.H., 2005. "Health care expenditures of immigrants in the United States: A nationally representative analysis," American Journal of Public Health, American Public Health Association, vol. 95(8), pages 1431-1438.
    2. Mireille Laroche, 2000. "Health Status and Health Services Utilization of Canada's Immigrant and Non-Immigrant Populations," Canadian Public Policy, University of Toronto Press, vol. 26(1), pages 51-75, March.
    3. Lasser, K.E. & Himmelstein, D.U. & Woolhandler, S., 2006. "Access to care, health status, and health disparities in the United States and Canada: Results of a Cross-National Population Based Survey," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1300-1307.
    4. Singh, G.K. & Siahpush, M., 2001. "All-cause and cause-specific mortality of immigrants and native born in the United States," American Journal of Public Health, American Public Health Association, vol. 91(3), pages 392-399.
    5. Lucas, J.W. & Barr-Anderson, D.J. & Kington, R.S., 2003. "Health Status, Health Insurance, and Health Care Utilization Patterns of Immigrant Black Men," American Journal of Public Health, American Public Health Association, vol. 93(10), pages 1740-1747.
    6. Carrasquillo, O. & Carrasquillo, A.I. & Shea, S., 2000. "Health insurance coverage of immigrants living in the United States: Differences by citizenship status and country of origin," American Journal of Public Health, American Public Health Association, vol. 90(6), pages 917-923.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rohitha Goonatilake & Susantha Herath, 2016. "The Economy of Healthcare: Disparity of Insured/Uninsured Profiles among European Immigrants in the United States," Eurasian Journal of Social Sciences, Eurasian Publications, vol. 4(1), pages 1-9.
    2. Bill McCarthy & Mikael Jansson & Cecilia Benoit, 2021. "Job Attributes and Mental Health: A Comparative Study of Sex Work and Hairstyling," Social Sciences, MDPI, vol. 10(2), pages 1-21, January.
    3. Astri Syse & Bjorn H. Strand & Oyvind Naess & Ólöf Anna Steingrímsdóttir & Bernadette N. Kumar, 2016. "Differences in all-cause mortality," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(22), pages 615-656.
    4. David E. Bloom & Elizabeth Cafiero & Eva Jané-Llopis & Shafika Abrahams-Gessel & Lakshmi Reddy Bloom & Sana Fathima & Andrea B. Feigl & Tom Gaziano & Ali Hamandi & Mona Mowafi & Danny O’Farrell & Emre, 2012. "The Global Economic Burden of Noncommunicable Diseases," PGDA Working Papers 8712, Program on the Global Demography of Aging.
    5. Noreen Goldman & Anne Pebley & Mathew Creighton & Graciela Teruel & Luis Rubalcava & Chang Chung, 2014. "The Consequences of Migration to the United States for Short-Term Changes in the Health of Mexican Immigrants," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1159-1173, August.
    6. Rod Missaghian, 2021. "Social Capital and Post-Secondary Decision-Making Alignment for Low-Income Students," Social Sciences, MDPI, vol. 10(3), pages 1-18, March.
    7. Viladrich, Anahí, 2012. "Beyond welfare reform: Reframing undocumented immigrants’ entitlement to health care in the United States, a critical review," Social Science & Medicine, Elsevier, vol. 74(6), pages 822-829.
    8. Jimenez, Anthony M., 2021. "The legal violence of care: Navigating the US health care system while undocumented and illegible," Social Science & Medicine, Elsevier, vol. 270(C).
    9. Kannikar Hannah Wechkunanukul & Shahid Ullah & Justin Beilby, 2022. "Variation in Seeking Care for Cardiovascular Disease and Ambulance Utilization among Migrants in Australia: Time, Ethnicity, and Delay (TED) Study III," IJERPH, MDPI, vol. 19(3), pages 1-14, January.
    10. Guixin Han & Pengcheng Liu & Yihang Zhao & Yinyin Liang & Xiaojie Wang, 2023. "The Influence of Foreign Direct Investment on Physical Health of Rural-Urban Migrants—Empirical Evidence from China Migrants Dynamic Survey," IJERPH, MDPI, vol. 20(5), pages 1-13, February.
    11. Prus, Steven G., 2011. "Comparing social determinants of self-rated health across the United States and Canada," Social Science & Medicine, Elsevier, vol. 73(1), pages 50-59, July.
    12. Ramraj, Chantel & Shahidi, Faraz Vahid & Darity, William & Kawachi, Ichiro & Zuberi, Daniyal & Siddiqi, Arjumand, 2016. "Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada," Social Science & Medicine, Elsevier, vol. 161(C), pages 19-26.
    13. G. Trohel & V. Bertaud-Gounot & M. Soler & P. Chauvin & Olivier Grimaud, 2016. "Socio-Economic determinants of the need for dental care in adults," Post-Print hal-01372359, HAL.
    14. Nguyen, Quynh C. & Hussey, Jon M. & Halpern, Carolyn T. & Villaveces, Andres & Marshall, Stephen W. & Siddiqi, Arjumand & Poole, Charles, 2012. "Adolescent expectations of early death predict young adult socioeconomic status," Social Science & Medicine, Elsevier, vol. 74(9), pages 1452-1460.
    15. Gilda Trohel & Valérie Bertaud-Gounot & Marion Soler & Pierre Chauvin & Olivier Grimaud, 2016. "Socio-Economic Determinants of the Need for Dental Care in Adults," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Morton Beiser & Feng Hou, 2014. "Chronic health conditions, labour market participation and resource consumption among immigrant and native-born residents of Canada," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(3), pages 541-547, June.
    2. Irma Elo & Neil Mehta & Cheng Huang, 2011. "Disability Among Native-born and Foreign-born Blacks in the United States," Demography, Springer;Population Association of America (PAA), vol. 48(1), pages 241-265, February.
    3. Margaret Ralston & Xavier Escandell, 2012. "Networks Matter: Male Mexican Migrants’ Use of Hospitals," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 31(3), pages 321-337, June.
    4. Kyunghwa Kwak, 2018. "Age and Gender Variations in Healthy Immigrant Effect: a Population Study of Immigrant Well-Being in Canada," Journal of International Migration and Integration, Springer, vol. 19(2), pages 413-437, May.
    5. Asanin, Jennifer & Wilson, Kathi, 2008. ""I spent nine years looking for a doctor": Exploring access to health care among immigrants in Mississauga, Ontario, Canada," Social Science & Medicine, Elsevier, vol. 66(6), pages 1271-1283, March.
    6. Dean, Jennifer Asanin & Wilson, Kathi, 2010. ""My health has improved because I always have everything I need here...": A qualitative exploration of health improvement and decline among immigrants," Social Science & Medicine, Elsevier, vol. 70(8), pages 1219-1228, April.
    7. Jiunn Wang & Laura Marsiliani & Thomas Renstrom, 2017. "Tax Reform, Unhealthy Commodities and Endogenous Health," Department of Economics Working Papers 2017_12, Durham University, Department of Economics.
    8. Shukri A. Hassan & Farah Mohamed & Najma Sheikh & Guiomar Basualdo & Nahom A. Daniel & Rahel Schwartz & Beyene Tewelde Gebreselassie & Yikealo K. Beyene & Luwam Gabreselassie & Kifleyesus Bayru & Beth, 2021. "“They Wait until the Disease Has Taking over You and the Doctors Cannot Do Anything about It”: Qualitative Insights from Harambee! 2.0," IJERPH, MDPI, vol. 18(23), pages 1-20, December.
    9. repec:pri:crcwel:wp08-15-ff is not listed on IDEAS
    10. Anna Tegunimataka, 2023. "The Health of Immigrant Youth in Denmark: Examining Immigrant Generations and Origin," Journal of International Migration and Integration, Springer, vol. 24(2), pages 659-694, June.
    11. Mosi Adesina Ifatunji & Yanica Faustin & Wendy Lee & Deshira Wallace, 2022. "Black Nativity and Health Disparities: A Research Paradigm for Understanding the Social Determinants of Health," IJERPH, MDPI, vol. 19(15), pages 1-40, July.
    12. Marco Marozzi & Mario Bolzan, 2018. "An Index of Household Accessibility to Basic Services: A Study of Italian Regions," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(3), pages 1237-1250, April.
    13. Duncan Gillespie & Meredith Trotter & Shripad Tuljapurkar, 2014. "Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1003-1017, June.
    14. Tianyuan Luo & Cesar L. Escalante, 2018. "Health care service utilization of documented and undocumented hired farmworkers in the U.S," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(7), pages 923-934, September.
    15. Santosh Jatrana & Ken Richardson & Samba Siva Rao Pasupuleti, 2018. "Investigating the Dynamics of Migration and Health in Australia: A Longitudinal Study," European Journal of Population, Springer;European Association for Population Studies, vol. 34(4), pages 519-565, October.
    16. Rees, Philip Howell & Wohland, Pia N. & Norman, Paul D., 2009. "The estimation of mortality for ethnic groups at local scale within the United Kingdom," Social Science & Medicine, Elsevier, vol. 69(11), pages 1592-1607, December.
    17. Lori J. Curtis & William J. MacMinn, 2008. "Health Care Utilization in Canada: Twenty-five Years of Evidence," Canadian Public Policy, University of Toronto Press, vol. 34(1), pages 65-88, March.
    18. Younsook Yeo, 2017. "Healthcare inequality issues among immigrant elders after neoliberal welfare reform: empirical findings from the United States," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 547-565, June.
    19. Jonathan Wadsworth, 2013. "Mustn't Grumble: Immigration, Health and Health Service Use in the UK and Germany," Fiscal Studies, Institute for Fiscal Studies, vol. 34(1), pages 55-82, March.
    20. Bukola Salami & Alleson Mason & Jordana Salma & Sophie Yohani & Maryam Amin & Philomena Okeke-Ihejirika & Tehseen Ladha, 2020. "Access to Healthcare for Immigrant Children in Canada," IJERPH, MDPI, vol. 17(9), pages 1-12, May.
    21. Ellen M. Gee & Karen M. Kobayashi & Steven G. Prus, 2003. "Examining the "Healthy Immigrant Effect" in Later Life: Findings from the Canadian Community Health Survey," Social and Economic Dimensions of an Aging Population Research Papers 98, McMaster University.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:69:y:2009:i:10:p:1452-1459. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.