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Immigrants: Coverage & Access to Care Reference Library
Key Data Policy Research Fact Sheets Webcasts/Presentations Key Organizations

Policy Research

Costs & Coverage
Health Indicators
Language, Interpretation, and Health Care Use
Populations
Welfare Reform

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Costs & Coverage

Alker, J., and M. Urrutia, National Council of La Raza and the Kaiser Commission on Medicaid and the Uninsured, Immigrants and Health Coverage: A Primer, October 2004.
This primer is designed to provide an introduction to some of the questions surrounding immigrants and health insurance coverage.

Alker, J., and J. Ng'andu, National Council of La Raza and the Kaiser Commission on Medicaid and the Uninsured, The Role of Employer-Sponsored Health Coverage for Immigrants: A Primer, June 2006. PDF icon
This primer examines the role of employer-based coverage for immigrants and the specific hurdles they face in obtaining coverage.

Artiga, S., and K. Schwartz, The Kaiser Commission on Medicaid and the Uninsured, Health Insurance Coverage and Access to Care for Low-Income Non-Citizen Children, May 2007. PDF icon
This brief examines health coverage and access to care for low-income, non-citizen children to provide insight into challenges they face in obtaining health insurance and accessing care.

Brown, R., Robert Wood Johnson Foundation, Immigrant and Citizenship Status Affect Health Insurance Coverage and Access to Health Care Services, December 2006.
This study uses data from the federal National Health Interview Survey to examine coverage and access to health care for immigrants in the United States.

Brown, R.E., R. Wyn, H. Yu, et al. 1999. Access to Health Insurance and Health Care for Children in Immigrant Families. Children of Immigrants, National Academy Press 126–186.
This book chapter discusses health insurance coverage and access to health care services among first-generation immigrant children and U.S. citizen or nonimmigrant children in immigrant families, compared to children in nonimmigrant families, and the role of public policies in children’s coverage. Using data from the Current Population Survey and National Health Interview Survey, the authors examine the effects of immigration and citizenship status and ethnicity on uninsurance rates and access to physician visits.

Buchmueller, T.C., A.T. Lo Sasso, I. Lurie, et al., University of Michigan Economic Research on the Uninsured, Immigrants and Employer-Provided Health Insurance, August 2005.
This analysis examines what share of immigrants are offered employer-sponsored health insurance and take-up rates among immigrants.

California Immigrant Policy Center, Immigrants and the U.S. Health Care System, September 2006. PDF icon
This issue brief provides information about immigrants' use of health care in the United States.

Capps, R., G.M. Kenney, and M.E. Fix, Urban Institute, Health Insurance Coverage of Children in Mixed-Status Immigrant Families, November 2003.
Using data from the 1999 and 2002 National Survey of America’s Families, this paper examines the health insurance coverage of low-income citizen children and looks at differences between children whose parents or caregivers responded to the survey in English and those who responded in Spanish.

Carrasquillo, O., A.I. Carrasquillo, and S. Shea. 2000. Health Insurance Coverage of Immigrants Living in the United States: Differences by Citizenship Status and Country of Origin. American Journal of Public Health 90(6):917–923.
Analyzing data from the 1998 Current Population Survey, this report outlines differences in health insurance coverage among groups of immigrants, depending on citizenship status and country of origin.

Downs-Karkos, S., Grantmakers in Health,Addressing the Mental Health Needs of Immigrants and Refugees, February 2004.PDF icon
This author outlines some of the immediate challenges immigrants face when settling in a new country—securing a job, finding a place to live, buying food, and enrolling their children in school—and the added obstacles to receiving mental health care.

Families USA, Analysis of the Medicaid Citizenship Documentation Regulations, July 2006. PDF icon
This health policy memo explains the Medicaid citizenship documentation requirement and the effect that it will have on American citizens and residents.

Fremstad, S., and L. Cox, Kaiser Commission on Medicaid and the Uninsured, Covering New Americans: A Review of Federal and State Policies Related to Immigrants’ Eligibility and Access to Publicly Funded Health Insurance, November 2004.
This brief provides an overview of health coverage challenges facing immigrants, the federal rules regarding immigrants’ eligibility for Medicaid and SCHIP, and state efforts to provide replacement coverage for immigrants who are ineligible for Medicaid and SCHIP. It also reviews actions states can take to encourage enrollment of eligible immigrants in public health coverage and to improve immigrants’ access to care.

Fronstin, P. June 2005. The Impact of Immigration on Health Insurance Coverage in the United StatesEmployee Benefit Research Institute 26(6).
This newsletter looks at the effect of immigrants on the nation’s overall health expenditures and its ability to provide health insurance for uninsured citizens.

Gardner, M., and J. Varon, Kaiser Commission on Medicaid and the Uninsured,Moving Immigrants from a Medicaid Look-Alike Program to Basic Health in Washington State: Early Observations, May 2004.
This report details the transition from state-funded Medicaid look-alike coverage to more limited coverage in Washington’s Basic Health program for certain immigrant families. It also examines outcomes for health care coverage and access for these individuals.

Goldman, D., J. Smith, and N. Sood, November/December 2006, Immigrants and the Cost of Medical Care, Health Affairs 25(6): 1700-1711.
This article examines the difference in health expenditure on foreign-born and American-born adults in the United States.  It finds that foreign-born adults account for a disproportionately small amount of spending, likely due to their better health and lack of health insurance.

Goldman, D.P., J.P. Smith, and N. Sood. November/December 2005. Legal Status and Health Insurance Among ImmigrantsHealth Affairs 24(6):1640–1653.
This analysis uses data from Los Angeles County to examine the legal and health insurance status of the foreign-born adult population.

Government Accountability Office, Undocumented Aliens – Questions Persist About Their Impact on Hospitals’ Uncompensated Care Costs, May 2004.  PDF icon
In response to a Congressional request, this analysis examines the relationship between treating undocumented aliens and hospitals’ uncompensated costs. It also examines federal funding available to help hospitals offset these costs and the responsibility of the Department of Homeland Security (Homeland Security) for covering medical expenses of sick or injured aliens encountered by Border Patrol and U.S. port-of-entry officials.

Holahan, J., and A. Cook, Kaiser Commission on Medicaid and the Uninsured, Are Immigrants Responsible for Most of the Growth of the Uninsured?, October 2005. PDF icon
This analysis examines how much immigrants contributed to growth in the uninsured population from 1994 to 2003.

Kaiser Commission on Medicaid and the Uninsured, Resources on Immigrants and Health Care Coverage, April 2006.
This page provides links to issue briefs, fact sheets, reports, and websites from the Kaiser Family Foundation on immigrants and health care.

Ku, L., and S. Matani. 2001. Left out: Immigrants' Access to Health Care and Insurance. Health Affairs 20(1):247– 256.
Using data from the National Survey of America’s Families (NSAF), the authors report on how immigrant status affects insurance coverage and the use of medical, dental, and mental health services by adults and children.

Lessard, G., and L. Ku. Spring 2003. Gaps in Coverage for Children in Immigrant Families. The Future of Children 13(1):101–115.
This article highlights some of the barriers that immigrant children face in securing health coverage and quality health services. The authors discuss strategies that have been adopted to overcome these barriers and offer policy recommendations for future steps to improve public health insurance programs for immigrant children.

Mohanty, S.A., Immigrant Policy Center, Unequal Access: Immigrants and U.S. Health Care, July 2006. PDF icon
This article examines the disparities in health care coverage and access between U.S. immigrants and the rest of the U.S. population.

Mohanty, S.A., S. Woolhandler, E.U. Himmelstein, et al. August 2005. Health Care Expenditures of Immigrants in the United States: A Nationally Representative AnalysisAmerican Journal of Public Health 95(8):1431–1438.
Using data from the 1998 Medical Expenditure Panel Survey, this analysis compares the health care expenditures of immigrants residing in the United States with health care expenditures of US-born persons.

National Health Law Program, Revised Resource Manual on Immigrant Access to Health Benefits Released by The Access Project and the National Health Law Program, August 2002.
This primer on health access for immigrants details and explains basic eligibility requirements for key federal and state programs and identifies issues that can be significant barriers to access to health care for immigrants and their families.

National Immigration Law Center, Facts About Immigrants' Low Use of Health Services and Public Benefits, September 2006. PDF icon
This issue brief examines immigrants' use of health services and public benefits.

National Immigration Law Center, Prenatal Coverage for Immigrants Through the State Children’s Health Insurance Program (SCHIP), June 2003. PDF icon
This issue brief discusses the option for states to extend SCHIP coverage to a fetus and the implications for coverage of prenatal care for immigrant women.

National Immigration Law Center, Immigrant-Friendly Health Coverage Outreach and Enrollment, June 2002.
This brief provides an overview of issues to be considered in efforts to expand coverage among immigrants. Issues include confidentiality, language access, sponsor liability, application assistance, and impact on green card applications.

Okie, S., August 2007, Immigrants and Health Care-At the Intersection of Two Broken Systems, New England Journal of Medicine, 357(6); 525-539. PDF icon
This article examines the role of immigrants in the U.S. health care system and the challenges they face in receiving health care and services.

Perkins, J., Kaiser Family Foundation, Ensuring Linguistic Access in Health Care Settings: An Overview of Current Legal Rights and Responsibilities, August 2003.
This report focuses on issues of linguistic access in health care settings and summarizes the legal rights and responsibilities of health care service and coverage providers.

Pourat, N., G. Lessard, A. Lulejian, et al., UCLA Center for Health Policy Research, Demographics, Health, and Access to Care of Immigrant Children in California: Identifying Barriers to Staying Healthy, March 2003.
This fact sheet uses the 2001 California Health Interview Survey data to examine the health status and access to care of immigrant children in California.

Rosenbaum, S., and P. Shin, Kaiser Family Foundation, Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care, 2005. PDF icon
This brief provides an overview of migrant and seasonal farmworkers and the health challenges they face and considers options for improving their health coverage and access to care.

Schur, C., and J. Feldman, The Commonwealth Fund, Running in Place: How Job Characteristics, Immigrant Status, and Family Structure Keep Hispanics Uninsured, May 2001.  PDF icon
Based on data from the National Health Interview Survey, the Survey of Income and Program Participation, and the Current Population Survey, the authors discuss how immigrant status, employment industries, job positions, and family composition may contribute to the high rates of uninsurance among immigrants.

Schwartz, K., and S. Artiga, The Kaiser Commission on Medicaid and the Uninsured, Health Insurance Coverage and Access to Care for Low-Income Non-Citizen Adults, June 2007.
This brief analyzes health insurance coverage and access for low-income non-citizen adults and discusses provider insights into the ostacles this population faces in obtaining coverage and receiving care.

Staiti, A., R.E. Hurley, and A. Katz, Center for Studying Health System Change, Stretching the Safety Net to Serve Undocumented Immigrants: Community Responses to Health Needs, February 2006.
This report describes ways in which communities address health care issues of undocumented immigrants and how these will change as the number of immigrants to the U.S. grows.

Strine, T.W., L.E. Barker, A.H. Mokdad, et al. 2002. Vaccination Coverage of Foreign-Born Children 19 to 35 Months of Age: Findings from the National Immunization Survey, 1999–2000. Pediatrics, 110(2):e15.  PDF icon
Using the National Immunization Survey, the authors estimate rates of insurance coverage among foreign-born and US-born children for a variety of vaccinations, and the implications for delivery of culturally competent care and public health immunization interventions.

Tumlin, K.C., W. Zimmermann, and J. Ost, Urban Institute, State Snapshots of Public Benefits for Immigrants: A Supplemental Report to Patchwork Policies, August 1999.
This report provides a one-page summary of each state's immigrant eligibility rules for cash, food, and health assistance programs.

Wang, M., and J. Holahan, Urban Institute, The Decline in Medicaid Use by Noncitizens since Welfare Reform, May 2003.  PDF icon
This brief compares changes in Medicaid enrollment between noncitizens and citizens from 1996 to 2001.

Zeldin, C., L. Nichols, and P. Harbage, New America Foundation Health Policy Program, Ensuring Health Coverage for California’s Immigrant Children, Working Paper #2, November 2005. PDF icon
This paper is part of a series to examine proposals to achieve universal health coverage, focusing on populations in need, such as immigrant children.

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Health Indicators

Aroian, K. 2001. Immigrant Women and their HealthAnnual Review of Nursing Research 19:179–226.
This chapter reviews 292 research articles published in journals during the 1990s about adult immigrant women's health, summarizing research findings on topics that were the major foci of research conducted in the 1990s, evaluating progress in research over the last decade, and making recommendations for research in the new millennium.

Berk, M.L., C.L. Schur, L.R. Chavez, et al. July/August 2000. Health Care Use Among Undocumented Latino ImmigrantsHealth Affairs 19(4):51–64.
Using data from a 1996/1997 survey of undocumented Latino immigrants in four sites, this study examines immigrants’ reasons for coming to the U.S., use of health care services, and participation in government programs.

Capps, R., M.E. Fix, J. Ost, et al., Urban Institute, The Health and Well-Being of Young Children of Immigrants, February 2005.
This report focuses on the health and well-being of young children under the age of six in immigrant families.

Flaskerud, J., and S. Kim. June 1999. Health Problems of Asian and Latino Immigrants. The Nursing Clinics of North America 34(2):359–380.
This article looks at risk factors to which immigrants are exposed due to the circumstances of immigration, such as poverty, war, educational opportunities, and protection of financial assets.  It also raises awareness of several issues that nurses caring for immigrants face, including public anti-immigrant sentiments and political attempts to limit health care and education to immigrants.

Heron, M., R.F. Schoeni, and L. Morales, RAND Labor & Population Program: Working Paper Series, Health Status of Older Immigrants in the United States, March 2002. PDF icon
Using data from the 1992-1995 National Health Interview Surveys, the authors explore health disparities within the immigrant population and between immigrants and natives of the same racial/ethnic group, focusing on the health status of immigrants aged 55 and over.

Kandula, N.R., M. Kersey, and N. Lurie. April 2004. Assuring the Health of Immigrants: What the Leading Health Indicators Tell UsAnnual Review of Public Health 25:357–376.
This paper discusses the health of immigrants from the perspective of the ten leading health indicators outlined in Healthy People 2010.

Lucas, J.W., D.J. Barr-Anderson, and R.S. Kington. July 2005. Health Status of Non-Hispanic U.S.-Born and Foreign-Born Black and White Persons: United States, 1992-95Vital and Health Statistics 10(226):1–20. PDF icon
This report describes differences in selected sociodemographic and health characteristics of the non-Hispanic U.S. population by race (Black and White) and nativity (U.S-born and foreign-born), using data from the 1992-95 National Health Interview Surveys.

Messias, D., and M. Rubio. May 2004. Immigration and Health. Annual Review of Nursing Research 22:101–134.
This integrated review examines research on the relationships between immigration and health, looking at studies of immigration into North America published since 1994. The reviewers provide suggestions for future research on health disparities as well as on possible health protective factors among diverse immigrant populations.

Muennig, P., and M. Fahs. September 2002. Health Status and Hospital Utilization of Recent Immigrants to New York CityPreventive Medicine 35(3):225–31.
This paper examines hospital utilization, estimated hospital costs, and mortality rates for U.S.-born, foreign-born, and Puerto Rican-born persons residing in New York City.

Schwarzwald, H. April 2005.Illnesses Among Recently Immigrated ChildrenSeminars in Pediatric Infectious Diseases 16(2):78–83.
This paper examines the health risks that children immigrating to the United States face, compared to the diseases that more commonly affect U.S.-born children.

Singh, G., and M. Siahpush. 2001. All-Cause and Cause-Specific Mortality of Immigrants and Native Born in the United States.American Journal of Public Health 91(3):392–399.
This study uses data from the National Longitudinal Mortality Study (1979-1989) to examine whether US-born people and immigrants 25 years or older differ in their risks of all-cause and cause-specific mortality and whether these differentials, if they exist, vary according to age, sex, and race/ethnicity.

Smith, L. Spring 2001. Health of America's Newcomers. Journal of Community Health Nursing 18(1):53–68.
This article describes the role federalism has played regarding newcomer health, including immigration policies, health issues such as infectious diseases and access to health care, and policy options for newcomer health care concerns.

Villarejo, D., D. Lighthall, D. Williams III, et al., California Endowment, Suffering in Silence: A Report on the Health of California's Agricultural Workers, 2000.  PDF icon
This report summarizes the initial findings of the first statewide, population-based survey on the health status of California’s agricultural workers, and provides baseline health status data for this labor force.

Williams, D. October 2005. The Health of U.S. Racial and Ethnic PopulationsThe Journals of Gerontology Series B: Psychological Sciences and Social Sciences 60(2):53–62.
This article provides an overview of racial and ethnic disparities in health in the United States, considering the ways in which immigrant status, race, and SES interact to affect health.

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Language, Interpretation, and Health Care Use

Andrulis, D., N. Goodman, and C. Pryor, The Access Project, What a Difference an Interpreter Can Make: Health Care Experiences of Uninsured with Limited English Proficiency, April 2002.
This report, based on a survey of 4,161 uninsured respondents from 16 cities, compares the perceptions and experiences of adults who needed and easily got an interpreter with those who needed and did not get an interpreter (or had difficulty getting one), and with other uninsured who did not need an interpreter.


Flores, G., M. Barton Laws, S.J. Mayo, et al. 2003. Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters. Pediatrics 111(1):6–14.
This study examines the frequency, categories, and potential clinical consequences of errors in medical interpretation, and the implications for third-party payer reimbursement for translation services.

Flores, G., The New England Journal of Medicine, Language Barriers to Health Care in the United States, June 2006.
This article examines the language barriers that exist in the U.S. health care system and the impact of these barriers on Americans who speak a language other than English.

Jacobs, E.A., D.S. Shepard, J.A. Suaya, et al. May 2004. Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services. American Journal of Public Health 94(5):866–869.
The authors assess the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency.

Ku, L., and T. Waidman, Kaiser Commission on Medicaid and the Uninsured, How Race/Ethnicity, Immigration Status, and Language Affect Health Insurance Coverage, Access to Care, and Quality of Care Among the Low-Income Population, August 2003. PDF icon
This report seeks to disentangle the roles that race, language and citizenship status play in insurance coverage, access to health care, and quality of health care, particularly for the low-income Latino population.

Ku, L., and G. Flores. 2005. Pay Now or Pay Later: Providing Interpreter Services In Health Care. Health Affairs 24(2):435–444.
This paper summarizes the scientific evidence concerning the effectiveness of medical interpretation services; examines selected demographics of the population with limited English proficiency; and explores options for financing interpretation services in healthcare settings.

National Health Law Program, Congressional Briefing: The Growing Need for Language Services, December 2004.
This briefing presents charts and trends on the limited-English proficiency population in the United States, and includes access to health care.

National Health Law Program,HIPAA and Language Services in Health Care, March 2005.
The purpose of this memo is to explain the Health Insurance Portability and Accountability Act and its impact on interpretation services provided in health care settings.

Perkins, J., National Health Law Program, Summary of State Law Requirements Addressing Language Needs in Health Care, January 2006.
This report summarizes state laws on language access requirements in the health care setting.

Perkins, J., M.R. Mannix, J. Daniel, et al. September/October 2004. Enforcing Language Access Rights: Trends and Strategies. Clearinghouse Review: Journal of Poverty Law and Policy.
The authors in this paper discuss various aspects of language access, including recent court trends on the enforceability of federal obligations to provide access, advocacy efforts to secure language access in public benefit programs, and California Rural Legal Assistance’s strategies for enforcement.

Weiss, L., T. Bauer, C. Hill, et. al., Language as a Barrier to Health Care for New York City Children in Immigrant Families, The New York Academy of Medicine, May 2006. PDF icon
This paper examines how language affects enrollment in insurance and use of health care services for immigrants in New York City.

Youdelman, M., and J. Perkins, The Commonwealth Fund, Providing Language Interpretation Services in Health Care Settings: Examples from the Field, May 2002. PDF icon
The report profiles a variety of programs around the country that provide interpretation services in health care settings and identifies federal, state, local, and private funding sources for interpretation services.

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Populations

Africans

Hyman, D.J., K. Ogbonnaya, V.N. Pavlik, et al. Autumn 2000. Lower Hypertension Prevalence in First-Generation African Immigrants Compared to US-Born African AmericansEthnicity and Disease 10(3):343–349.
The authors refer to a cross-sectional survey of African-born and U.S.-born African-American health professionals to compare the two groups for the prevalence of hypertension and risk factors for hypertension.

Lucas, J.W., D.J. Barr-Anderson, and R.S. Kington. October 2003. Health Status, Health Insurance, and Health Care Utilization Patterns of Immigrant Black MenAmerican Journal of Public Health 93(10):1740–1747.
This study describes the health status, health insurance, and health care utilization patterns of the growing population of immigrant Black men, using data from the 1997-2000 National Health Interview Surveys.

Read, J., M. Emerson, and A. Tarlov. July 2005. Implications of Black Immigrant Health for U.S. Racial Disparities in HealthJournal of Immigrant Health 7(3):205–12.
This paper uses data from the 2000 and 2001 National Health Interview Surveys (NHIS) to compare the status of U.S.- and foreign-born blacks to that of U.S.-born whites on several health measures.

Summit Health Institute for Research and Education, Inc., Printed by the California Endowment,Giving Voices to the Voiceless: Language Barriers & Health Access Issues of Black Immigrants of African Descent, March 2005. PDF icon
This paper reports on the effects of language and cultural issues on access to culturally competent health care for Black immigrants of African descent.

Asians

The Asian American Coalition, The California Endowment, Are We Caring for Our Elderly? Health & The Ageing Laotian, June 2001. PDF icon
This publication looks at the Laotian population’s health and highlights the topic of refugee health care.

Frisbie, W.P., Y. Cho, and R.A. Hummer. February 2001. Immigration and the Health of Asian and Pacific Islander Adults in the United StatesAmerican Journal of Epidemiology 15(4):372–80.
The authors refers to 1992-1995 National Health Interview Survey data to examine the effects of nativity and duration of residence in the United States on the health of Asian and Pacific Islander immigrants.

Kuo, J.A., and K. Porter. August 1998. Health Status of Asian Americans: United States, 1992– 94Advance Data 7(298):1–16. PDF icon
This report uses the 1992-1994 National Health Interview Survey to compare the health status of six Asian national origin groups (Chinese, Filipino, Asian Indian, Japanese, Vietnamese, and Korean), with the Asian and Pacific Islander population as a whole and the non-Hispanic white population.

Meleis, A.I., L.G. Lipson, and S.M. Paul. April 1992., Ethnicity and Health Among Five Middle Eastern Immigrant GroupsApplied Nursing Research 41(2):98–103.
The authors study the relationships among immigration, ethnic identity, and health of Middle Eastern immigrants, and examine the need to consider ethnic identity as well as country of origin in providing care for clients.

Niedzwiecki, M., E.Y. Yang, and S. Earm, Southeast Asia Resource Action Center & the California Endowment, Southeast Asian American Elders in California, October 2003. PDF icon
This report contains data on health and citizenship status for Southeast Asian American elders in California.

Yu, S.M., Z.J. Huang, and G.K. Singh. January 2004. Health Status and Health Services Utilization Among US Chinese, Asian Indian, Filipino, and Other Asian/Pacific Islander Children. Pediatrics 113(1):101–107.
This study examines health status, access, and utilization measures of U.S.- and foreign-born Chinese, Asian Indian, Filipino, other Asian/Pacific Islander (API), and non-Hispanic white children by using from the National Health Interview Survey from 1997 to 2000.

Latinos

Aguirre International, The California Farm Labor Force Overview and Trends from the National Agricultural Workers Survey, 2005.  PDF icon
This report examines various trends among California farm workers, most of whom are immigrants, including health insurance, access to care, and health risk factors.

Doty, M., The Commonwealth Fund, Hispanic Patients’ Double Burden: Lack of Health Insurance and limited English, February 2003.
Drawing on findings from the Commonwealth Fund 2001 Health Care Quality Survey, this analysis compares measures of health care access and quality between non-English speaking Hispanics to other groups and discusses the relationship between limited English skills and lack of health insurance.

Flores, G., M. Abreu, M.A. Olivar, et al. 1998. Access Barriers to Health Care for Latino Children. Archives of Pediatrics and Adolescent Medicine 152(11):1119–1125.
Based on findings from a survey of parents who brought their children to a pediatric Latino clinic at an inner-city hospital, the authors identify major barriers to accessing health care for children and the impact of these barriers on health outcomes.  Barriers include language problems, cultural differences, poverty, lack of health insurance, transportation difficulties, and long waiting times.

Gutierrez, V.F., S.P. Wallace, and X. Castaneda, UCLA Center for Health Policy Research & California-Mexico Health Initiative, Demographic Profile of Mexican Immigrants in the United States, October 2004.
This Binational Health Week fact sheet describes the demographics and basic health status of the nine million Mexican immigrants living in the U.S. It is based on published data and original analyses of the 2000 National Health Interview Survey.

Huezo, C., National Council of La Raza, Hispanic Health in California, March 2002, June 2004.
This fact sheet highlights the disproportionate rate of uninsured Latinos as well as cultural and linguistic barriers to care, and subsequent health disparities.

Marshall, K.J., X. Urrutia-Rojas, F.S. Mas, et al. November/December 2005. Health Status and Access to Health Care of Documented and Undocumented Immigrant Latino Women.Health Care for Women International 26(10):916–936.
Using secondary data from a cross-sectional study, the authors examine sociodemographic, migration, health status, and access to health care characteristics of immigrant documented and undocumented Latino women in North Texas.

McNeece, C.A., M.K. Falconer, and D. Springer. 2002. Impact of Immigration on Health and Human Services: Florida’s ExperienceSocial Work in Health Care 35 (1–2):501–522.
This article describes the immigration experience of Haitians and Cubans in Florida, and the impact of federal policies on the state’s ability to meet the service needs of these populations. The article examines several service categories, including education, social services, health care, and criminal justice.

Morales, L.S., M. Lara, R.S. Kington, et al. November 2002. Socioeconomic, Cultural, and Behavioral Factors Affecting Hispanic Health OutcomesJournal of Health Care for the Poor and Underserved 13(4):477–503.
In this paper, the authors selectively review data and research on the “epidemiological paradox”—despite higher poverty rates, less education, and worse access to health care, some health outcomes of many Hispanics are equal to, or better than, those of non-Hispanic whites.

National Council of La Raza, Hispanic Health Data, Updated periodically.
This webpage provides links to sources of information about insurance and citizenship status, language barriers to quality health care, and health disparities among Latinos.

National Population Council of the Government of Mexico & University of California, Printed by the California Endowment,Mexico-United States Migration: Health Issues, October 2005. PDF icon
This report describes the volume, trends, and characteristics of Mexican migration to the United States and analyzes immigrants’ health concerns, such as the availability of medical insurance coverage and access to and use of medical services.

Shah, N. S., and O. Carrasquillo, November/December 2006, Twelve-Year Trends in Health Insurance Coverage Among Latinos, By Subgroup and Immigration Status, Health Affairs 25(6): 1612-1619.
This article explores trends in the Latino population in the United States from 1993-1999.  It examines insurance trends based on subgroup and policy.

Thomas-Breitfeld, S., and E. Rodriguez, National Council of La Raza, Welfare Reform 2002: Helping Latino Families Move from Welfare to Work, January 2002.
This publication examines proposals for reforming the Temporary Assistance for Needy Families (TANF) block grant, the primary cash assistance program for poor families and children.

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Welfare Reform

Carrasquillo, O., D.H. Ferry, J. Edwards, et al. 2003. Eligibility for Government Insurance if Immigrant Provisions of Welfare Reform Are Repealed. American Journal of Public Health 93:1680–1682.
This study discusses the decline in Medicaid and SCHIP coverage among immigrants, following enactment of the 1996 welfare legislation. The analysis draws on data from the Current Population Survey to model eligibility for immigrant children and their parents if the immigrant provisions were repealed.

Choi, S., April 2006, Insurance Status and Health Service Utilization Among Newly-Arrived Older Immigrants, Journal of Immigrant and Minority Health 8(2); 149-161.
This study examines the relationship between immigrant status, health insurance, and health service use among older immigrants following the 1996 welfare reform. 

Fix, M., and J. Passel, Urban Institute,The Scope and Impact of Welfare Reform’s Immigrant Provisions, January 2002.
Relying on 1995–2000 Current Population Survey (CPS) data, this discussion paper distinguishes between legal immigrants, refugees, naturalized citizens and undocumented immigrants in the context of welfare reform. It focuses on welfare provisions for families with children whose incomes are below 200 percent of poverty.

Fix, M., and W. Zimmerman, Urban Institute, Welfare Reform: A New Immigrant Policy for the United States, April 1997.
This report reviews the history of the public welfare system, specifically the Aid to Families with Dependent Children (AFDC) program, comparing the major themes, issues, and compromises found in the Family Support Act of 1988 to AFDC's original policy goals and program structure.

Gold, R. May 2003. Immigrants and Medicaid after Welfare ReformThe Guttmacher Report on Public Policy. PDF icon
This analysis looks at eligibility, issues of access, and immigrant health coverage in light of the 1996 federal changes to Medicaid, focusing in particular on immigrant women’s reproductive health.

Hagan, J., N. Rodriguez, R. Capps, et al. Summer 2003. The Effects of Recent Welfare and Immigration Reforms on Immigrants’ Access to Health CareThe International Migration Review 37(2):444–463.
This study investigates the impact of the Personal Responsibility and Work Opportunity Reconciliation Act and the Illegal Immigration Reform and Immigrant Responsibility Act, both passed in 1996, on the use of health-care services in immigrant communities in five Texas counties.

Kaushal, N., and R. Kaestner, June 2005, Welfare Reform and Health Insurance of ImmigrantsHealth Services Research 40(3):697-722.
This study examines the impact of the Personal Resposibility and Work Opportunity Reconciliation Act on health insurance coverage of foreign- and U.S.-born families headed by low-educated women.

Kaushal, N., and R. Kaestner, April 2007, Welfare Reform and Health of Immigrant Women and Their Children, Journal of Immigrant and Minority Health 9(2); 61-74.
This paper examines the association between welfare reform and health insurance, medical care use, and health of low-educated, foreign-born, single mothers and their children.

Maloy, K.A., J. Darnell, L. Nolan, et al. May 2000. Effects of the 1996 Welfare and Immigration Reform Laws on the Ability and Willingness of Immigrants to Access Medicaid and Health Care Services. George Washington University.
In this study, the authors examine implementation of new Medicaid eligibility requirements for immigrants after the 1996 welfare reform and the impact of these requirements on immigrants’ access to health services in four sites: Chicago, IL, Washington DC; San Diego, CA, and Brownsville, TX.

Singer, A. 2001. Immigrants, Their Families, and Their Communities in the Aftermath of the Welfare ReformResearch Perspectives on Migration 3(1). PDF icon
This issue brief summarizes studies from the Immigrants and Welfare Research Network that address the economic and social changes within immigrant families and communities—particularly in California, New York, Texas, Illinois, and Florida—that have accompanied the shifts in eligibility for public assistance.

Tumlin, K., and W. Zimmerman, Urban Institute, Immigrants and TANF: A Look at Immigrant Welfare Recipients in Three Cities, October 2003.  PDF icon
This report focuses on the experiences of immigrants and those who are limited English proficient on TANF in Houston, Los Angeles, and New York City. The authors examine immigrant participation in welfare, employment patterns and barriers among immigrant welfare recipients, and opportunities for and limits to enrollment in English as a Second Language and other training programs while on the welfare rolls.

Zimmerman, W., and M. Fix, Urban Institute, Declining Immigrant Applications for Medi-Cal and Welfare Benefits in Los Angeles County, July 1998.
This report, based on an analysis of administrative data from the Los Angeles County Department of Public Social Services, explores a number of reasons why fewer immigrants were applying for assistance for which they remained eligible.

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