State-Level Health Care Access and Use Among Children in US Immigrant Families

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014–2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women’s barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. Published online ahead of print September 2, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306455 )

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States with fewer criminalizing immigrant policies have smaller health care inequities between citizens and noncitizens

BMC Public Health ◽

10.1186/s12889-020-09525-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Maria-Elena De Trinidad Young ◽

Hiram Beltrán-Sánchez ◽

Steven P. Wallace

Keyword(s):

Health Care ◽

Health Care Access ◽

State Level ◽

Comparative Approach ◽

Usual Source Of Care ◽

Data Set ◽

Logistic Regression Models ◽

Usual Source ◽

Care Access ◽

Source Of Care

Abstract Background In the last thirty years, major shifts in immigrant policy at national and state levels has heightened boundaries among citizens, permanent residents, and those with other statuses. While there is mounting evidence that citizenship influences immigrant health care inequities, there has been less focus on how policies that reinforce citizenship stratification may shape the extent of these inequities. We examine the extent to which the relationship between citizenship and health care inequities is moderated by state-level criminalization policies. Methods Taking a comparative approach, we assess how distinct criminalization policy contexts across US states are associated with inequitable access to care by citizenship status. Utilizing a data set with state-level measures of criminalization policy and individual-level measures of having a usual source of care from the National Health Interview Survey, we use mixed-effects logistic regression models to assess the extent to which inequities in health care access between noncitizens and US born citizens vary depending on states’ criminalization policies. Results Each additional criminalization policy was associated with a lower odds that noncitizens in the state had a usual source of care, compared to US born citizens. Conclusion Criminalization policies shape the construction of citizenship stratification across geography, such as exacerbating inequities in health care access by citizenship.

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Geography matters: state-level variation in children's oral health care access and oral health status

Public Health ◽

10.1016/j.puhe.2015.04.024 ◽

2016 ◽

Vol 134 ◽

pp. 54-63 ◽

Cited By ~ 16

Author(s):

S.A. Fisher-Owens ◽

M.J. Soobader ◽

S.A. Gansky ◽

I.A. Isong ◽

J.A. Weintraub ◽

...

Keyword(s):

Health Care ◽

Health Status ◽

Oral Health ◽

Health Care Access ◽

State Level ◽

Oral Health Status ◽

Level Variation ◽

Care Access ◽

Oral Health Care Access ◽

Children’S Oral Health

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State–Level Sexism and Gender Disparities in Health Care Access and Quality in the United States

Journal of Health and Social Behavior ◽

10.1177/00221465211058153 ◽

2021 ◽

pp. 002214652110581

Author(s):

Kristen Schorpp Rapp ◽

Vanessa V. Volpe ◽

Tabitha L. Hale ◽

Dominique F. Quartararo

Keyword(s):

United States ◽

Health Care ◽

Health Care Access ◽

Political Representation ◽

State Level ◽

The United States ◽

Gender Disparities ◽

Individual Level ◽

Care Access ◽

Access And Quality

In this investigation, we examined the associations between state-level structural sexism—a multidimensional index of gender inequities across economic, political, and cultural domains of the gender system—and health care access and quality among women and men in the United States. We linked administrative data gauging state-level gender gaps in pay, employment, poverty, political representation, and policy protections to individual-level data on health care availability, affordability, and quality from the national Consumer Survey of Health Care Access (2014–2019; N = 24,250). Results show that higher state-level sexism is associated with greater inability to access needed health care and more barriers to affording care for women but not for men. Furthermore, contrary to our hypothesis, women residing in states with higher state-level sexism report better quality of care than women in states with lower levels of sexism. These findings implicate state-level sexism in perpetuating gender disparities in health care.

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