Spanish Speakers Have Difficulty Accessing Health Care in U.S.

Spanish language dominance is a transitional status routinely found in immigrant groups, especially recent arrivals, and not a permanent impediment that is passed forward to new generations, Vega said. "Regrettably, a disproportionate percentage of Latino immigrant families are also in poverty, which is the real impediment to receipt of medical care of adequate quality," he said.

The authors of the study are correct that self-reported health status is not accurate for Latino immigrants, Vega said. "In fact, it is contradicted by self-reported lower ratings of health problems and chronic medical conditions in major health surveys going back 20 years," he noted.

Rea Panares, director of Minority Health Initiatives at Families USA, said the main problem of access to health care among Spanish-speaking Americans is lack of health insurance, not language.

"One of the barriers to access is language, and we have seen that in a number of different reports and studies in the past," Panares said. "Spanish-speaking patients are less likely to have access to health care, mainly due to cultural and language barriers."

More than 70 percent of Spanish-speaking Hispanics are uninsured, particularly in new growth areas, Panares said. "That's a stark finding," she said. Part of the problem is that the federal government does not reimburse states for health-care costs for new legal immigrants.

Panares noted that there is a federal five-year ban on eligibility for public benefits for all legal, documented immigrant children and pregnant women. While some states offer benefits, others do not, she said. "This points to why we need national health-care reform," Panares said.

Another study in the same journal found that along the U.S.-Mexican border, the number of uninsured increased 7 percent from 2000 to 2005.

"Results from this study indicate that existing disparities in health-care access will continue to undermine the health status of the region's population unless major health-care policy reforms are initiated to promote greater accessibility to U.S. health care," the University of Texas researchers concluded.

In a third study, researchers from the Children's Hospital of Philadelphia found poor U.S.-born children were as likely as foreign-born children to have public insurance coverage. But after 2000, foreign-born children were 1.59 times more likely to be uninsured compared with U.S.-born children.

"In the various discussions of proposals for universal child health coverage, policies designed to promote the healthy growth of this highly under-served population merit serious consideration, given their potential to ensure the future socioeconomic well-being of an increasingly diverse American population," the authors wrote.

More information

For more on access to health care, visit Families USA.

SOURCES: C. Annette DuBard, M.D., M.P.H., Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill; William Vega, Ph.D., professor, family medicine, David Geffen School of Medicine, University of California, Los Angeles; Rea Panares, director, Minority Health Initiatives, Families USA; Sept. 17, 2008,American Journal of Public Health, online