Presenting Author: Brent A. Langellier, PhD, Drexel University Dornsife School of Public Health

ABSTRACT

Background: Educational attainment is an important social determinant of health, but emerging research suggests that U.S. and foreign-born Mexican Americans demonstrate an unusually weak relationship between education and many health outcomes.

Objectives: To examine the educational gradient in access and use of health care services among Mexican-descent groups that represent different stages of the migration continuum: the Mexican population in Mexico, first-generation Mexican immigrants and second or greater generation Mexican Americans living in California, and active migrants making northbound or southbound trips across the U.S.-Mexico border.

Methods: We use data from three representative surveys to characterize educational gradients in health care access and use among Mexican-origin sub-populations.

Results: We find evidence of substantive between-group differences in some but not all measures of health care access and use. For example, our data suggest a statistically significant educational gradient in health insurance coverage among Mexicans living in Mexico and foreign-born Mexican Americans in California, but not among U.S.-born Mexican Americans or active migrants. Lack of gradients reflects two distinct patterns in insurance coverage: the U.S.-born lack gradients due to uniformly moderate levels of insurance coverage, while most active migrants, particularly the deported, have uniformly low levels of coverage.

Implications: Heterogeneous gradients may reflect social, structural, and economic barriers to care that uniquely affect particular sub-groups (e.g., all undocumented immigrants in the U.S. and many documented immigrants are excluded from public insurance programs). Understanding why educational gradients differ between populations yields insight to understanding and addressing education disparities in health behaviors and outcomes.

Authors: Brent A. Langellier, PhD; Ana P. Martínez-Donate, PhD; J. Eduardo Gonzalez-Fagoaga, PhD; and M. Gudelia Rangel, PhD.