Table 2.
Multivariate logistic regression analyses of immigration-related factors and health care access and utilization among immigrant adults
| (1) Usual source |
(2) Doctor visit |
(3) Delay prescr |
(4) Delay treatment |
|||||
|---|---|---|---|---|---|---|---|---|
| OR | 95 % CI | OR | 95 % CI | OR | 95 % CI | OR | 95 % CI | |
| Immigration-related factors | ||||||||
| Length of residency | ||||||||
| 0–4 years (reference) | ||||||||
| 5–9 years | 2.14 | (0.99–4.62)# | 1.79 | (0.84–3.81) | 0.52 | (0.17–1.56) | 0.39 | (0.17–0.86)* |
| 10–14 years | 1.93 | (0.93–4.04)# | 1.69 | (0.83–3.43) | 1.10 | (0.32–3.81) | 0.45 | (0.18–1.11)# |
| 15+years | 2.38 | (1.16–4.87)* | 1.26 | (0.67–2.39) | 1.09 | (0.40–2.91) | 0.42 | (0.19–0.94)* |
| Limited English proficiency (LEP) | 1.17 | (0.48–2.83) | 0.79 | (0.35–1.78) | 0.34 | (0.10–1.11)# | 0.17 | (0.06–0.50)** |
| Interaction between length of residency and LEP | ||||||||
| 0–4 years * LEP (reference) | ||||||||
| 5–9 years * LEP | 0.64 | (0.23–1.77) | 0.76 | (0.28–2.02) | 3.58 | (0.84–15.22)# | 4.20 | (1.16–15.16)* |
| 10–14 years * LEP | 0.60 | (0.22–1.64) | 0.72 | (0.28–1.86) | 1.13 | (0.25–5.06) | 2.67 | (0.80–8.95) |
| 15+years * LEP | 0.38 | (0.16–0.93)* | 0.90 | (0.39–2.06) | 1.25 | (0.36–4.32) | 3.10 | (0.97–9.88)# |
| Non-citizen | 0.75 | (0.56–1.01)# | 0.92 | (0.70–1.22) | 0.94 | (0.58–1.51) | 0.68 | (0.43–1.07)# |
| Race | ||||||||
| African American (reference) | ||||||||
| American Indian/Alaskan Native | 0.30 | (0.08–1.15)# | 0.26 | (0.08–0.78)* | 0.37 | (0.09–1.44) | 0.85 | (0.26–2.82) |
| Asian | 0.71 | (0.21–2.42) | 0.26 | (0.11–0.63)** | 0.56 | (0.23–1.36) | 0.43 | (0.18–1.03)# |
| Multirace | 1.20 | (0.27–5.38) | 0.48 | (0.12–1.84) | 1.13 | (0.20–6.30) | 0.29 | (0.09–0.99)* |
| Other single race | 0.82 | (0.25–2.71) | 0.31 | (0.13–0.74)** | 0.64 | (0.25–1.64) | 0.60 | (0.26–1.40) |
| Pacific Islander | 3.55 | (0.37–33.92) | 1.22 | (0.22–6.82) | 0.48 | (0.04–5.43) | 1.24 | (0.13–11.47) |
| White | 0.90 | (0.27–3.04) | 0.41 | (0.17–0.97)* | 0.57 | (0.24–1.36) | 0.68 | (0.29–1.57) |
| Predisposing factors | ||||||||
| Age | ||||||||
| 18–21 (reference) | ||||||||
| 22–29 | 1.24 | (0.61–2.52) | 2.33 | (1.06–5.15)* | 1.25 | (0.38–4.10) | 1.92 | (0.60–6.13) |
| 30–39 | 1.63 | (0.78–3.40) | 3.17 | (1.43–7.05)** | 1.92 | (0.58–6.33) | 1.87 | (0.60–5.81) |
| 40–49 | 1.99 | (0.97–4.10)# | 3.64 | (1.63–8.15)** | 1.74 | (0.53–5.71) | 2.33 | (0.73–7.44) |
| 50–59 | 2.04 | (0.97–4.30)# | 3.70 | (1.64–8.33)** | 1.98 | (0.59–6.73) | 1.46 | (0.44–4.77) |
| 60–69 | 2.62 | (1.22–5.65)* | 4.75 | (2.06–10.95)*** | 1.18 | (0.35–3.96) | 0.92 | (0.27–3.14) |
| 70+ | 3.15 | (1.40–7.07)** | 4.66 | (1.98–10.95)*** | 1.31 | (0.37–4.62) | 0.78 | (0.19–3.19) |
| Male | 0.62 | (0.49–0.79)*** | 0.44 | (0.39–0.49)*** | 0.93 | (0.64–1.34) | 0.79 | (0.58–1.09) |
| Married | 0.98 | (0.61–1.57) | 1.43 | (0.85–2.41) | 0.70 | (0.38–1.30) | 0.80 | (0.46–1.39) |
| Education | ||||||||
| Less than high school (reference) | ||||||||
| High school | 1.07 | (0.81–1.42) | 0.85 | (0.65–1.10) | 1.13 | (0.69–1.83) | 1.05 | (0.71–1.56) |
| College | 1.12 | (0.76–1.64) | 1.02 | (0.70–1.49) | 1.16 | (0.73–1.86) | 1.09 | (0.73–1.61) |
| Employed | 1.03 | (0.25–4.31) | 2.87 | (1.09–7.57)* | 6.08 | (1.41–26.24)* | 2.80 | (0.75–10.40) |
| Family type | ||||||||
| Married with kids (reference) | ||||||||
| Married, no kids | 1.06 | (0.75–1.51) | 1.41 | (1.03–1.94)* | 1.54 | (0.87–2.71) | 1.34 | (0.83–2.19) |
| Single adult, 21+ | 0.79 | (0.46–1.34) | 1.70 | (0.95–3.06)# | 1.28 | (0.68–2.41) | 1.11 | (0.61–2.01) |
| Single with kids | 0.70 | (0.40–1.26) | 1.38 | (0.72–2.62) | 1.16 | (0.55–2.42) | 0.74 | (0.39–1.43) |
| Single young adult, 19–20 | 0.48 | (0.14–1.66) | 1.62 | (0.46–5.75) | 0.36 | (0.04–3.06) | 1.89 | (0.38–9.31) |
| Single, 18 years old | 0.54 | (0.18–1.59) | 2.86 | (0.88–9.28)# | 0.19 | (0.03–1.37)# | 0.19 | (0.03–1.23)# |
| Enabling factors | ||||||||
| Currently insured | 4.30 | (3.17–5.83)*** | 3.01 | (2.31–3.93)*** | 1.80 | (1.04–3.12)* | 0.65 | (0.40–1.07)# |
| Public assistance | ||||||||
| TANF/CalWorks participation | 0.77 | (0.38–1.54) | 0.53 | (0.25–1.10)# | 0.87 | (0.43–1.73) | 1.95 | (0.79–4.82) |
| Food stamps participation | 0.90 | (0.58–1.40) | 0.87 | (0.59–1.28) | 0.99 | (0.59–1.65) | 0.98 | (0.52–1.87) |
| SSI participation | 1.76 | (1.02–3.05)* | 1.82 | (1.10–3.04)* | 1.19 | (0.53–2.65) | 0.78 | (0.32–1.87) |
| WIC participation | 0.92 | (0.57–1.49) | 1.34 | (0.84–2.15) | 1.78 | (0.92–3.43)# | 1.19 | (0.69–2.07) |
| Medical participation | 0.56 | (0.39–0.82)** | 0.78 | (0.53–1.15) | 0.68 | (0.40–1.15) | 1.14 | (0.64–2.05) |
| Family poverty level (% of Federal Poverty Level) | ||||||||
| 0–99 % FPL (reference) | ||||||||
| 100–199 % FPL | 1.22 | (0.91–1.62) | 0.84 | (0.63–1.12) | 0.60 | (0.36–1.00)*a | 0.95 | (0.58–1.55) |
| 200–299 % FPL | 1.81 | (1.21–2.69)** | 1.31 | (0.91–1.89) | 0.89 | (0.42–1.91) | 0.93 | (0.47–1.85) |
| 300 % FPL and above | 1.57 | (1.02–2.40)* | 1.30 | (0.88–1.92) | 0.62 | (0.32–1.21) | 1.28 | (0.66–2.47) |
| Household size | 0.99 | (0.92–1.07) | 1.05 | (0.98–1.13) | 1.01 | (0.88–1.16) | 1.00 | (0.87–1.14) |
| Community type | ||||||||
| Need factor | ||||||||
| Self-reported general health status | ||||||||
| Excellent (reference) | ||||||||
| Very good | 1.24 | (0.82–1.88) | 1.06 | (0.76–1.48) | 1.91 | (1.12–3.27)* | 1.77 | (1.13–2.78)* |
| Good | 1.33 | (0.90–1.96) | 1.40 | (1.03–1.90)* | 1.75 | (1.12–2.75)* | 1.65 | (1.01–2.69)* |
| Fair | 1.40 | (0.92–2.11) | 1.82 | (1.29–2.57)*** | 5.51 | (3.31–9.18)*** | 3.35 | (2.01–5.57)*** |
| Poor | 2.39 | (1.24–4.63)** | 5.04 | (2.91–8.72)*** | 7.67 | (4.10–14.33)*** | 5.43 | (2.40–12.30)*** |
| Constant | 0.74 | (0.12–4.56) | 0.68 | (0.16–2.93) | 0.03 | (0.00–0.19)*** | 0.25 | (0.03–1.74) |
| Observations | 11,481 | 11,481 | 11,481 | 11,481 | ||||
The italics indicate the three classes of factors predicting health services use in the Andersen model
OR odds ratio, 95 % CI 95 % confidence interval
#
p<0.1;
*
p<0.05;
**
p<0.01,
***
p<0.001
a
Confidence interval reported with rounding to two decimal places. Actual values five decimal places are (0.358596–0.997563).