Predictors of Routine Medical Care Use among Mexican Immigrants/Mexican-Americans Varying in Legal Status

Background: Immigration has been the focus of intense political debate, with a recurrent theme being the use of public services, including healthcare. Although Latinos are the largest and fastest growing ethnic group in the United States (U.S.), evidence suggests they underutilize healthcare, with Mexican Immigrants and Mexican Americans (MI-MA) living on the U.S.-Mexico border exhibiting the greatest disparities. Objective: This study explored the association of predisposing, enabling and need characteristics, including legal status, with the use of routine medical care (RMC) among 387 MI-MA living on the California-Mexico border. Methods: This cross-sectional study used data collected in 2009 for the San Diego Prevention Research Center (SDPRC) community survey; data analyses were completed in Summer 2012. This study involved multistage sampling and recruitment of Latino adults in 200 census blocks near the California-Mexico border to complete an interview and height and weight measurements. Sequential logistic regressions assessed the relative contribution of predisposing, enabling and need factors to the use of RMC. Results: Predisposing and enabling factors (gender, undocumented status, cost) distinguished between respondents with recent (<1 year) versus limited (≥ 5 years including never) use of RMC, whereas enabling and need factors (insurance, dispositional trust, presence of a chronic illness) adequately differentiated between those with recent versus delayed (≥1 year, but <5 years) use. Undocumented status distinguished between those with delayed versus limited use of RMC. Conclusions: Consideration of different factors, including financial difficulties and legal status, is necessary for promoting use of RMC among MI-MA living in this border region