Organizational Perspectives on the Public Charge Rule and Health Care Access for Latino Immigrants in California.

Objective: To examine how mis- and disinformation about the Public Charge Ground of Inadmissibility final rule ("public charge rule") influences health care access for Latino immigrants in California as seen through the perspectives of leaders in health-serving organizations.

Study Setting And Design: This qualitative study included semi-structured interviews with healthcare and community-based organizational leaders serving Latino immigrants in California. Viswanath et al.

Equity in Health Care Access, Utilization, and Experiences for Latino Children in California by Parental Citizenship and Household Language, 2021-22.

Objective: This study examines health care access, utilization, and experiences among Latino children in California by parental citizenship and household language.

Methods: Merged data from the 2021-22 California Health Interview Survey and the follow-up Latino Youth Health Study of the same years were analyzed. Primary outcomes were parental reports of children's health care access, utilization, and experiences in the past year.

Does Early Life Adversity Limit Delivery of High-Quality Health Care Among Children?

Background: Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making.

Methods: Using data from the 2021-2022 National Survey of Children's Health (n = 47 179) the association between ACEs, both individual and cumulative and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making.

The American Rescue Plan Act and Access to Health Care for Latinos According to Citizenship Status.

Objective: We studied patterns in health care access between Latino and non-Latino White adults according to citizenship status before and after the American Rescue Plan Act (ARPA) of 2021 was enacted to determine whether inequities changed.

Methods: This study used 2019-2022 National Health Survey Interview data. Differences in predicted probabilities from logistic regression models were used to estimate changes in health care access outcomes (any insurance coverage, private insurance coverage, delaying care due to cost, and having a usual source of care) among Latino citizens, Latino noncitizens, and non-Latino White citizens in periods before and after ARPA's enactment (2019-2020 vs 2021-2022).

Health Care Access and Utilization and the Latino Health Paradox.

Background: The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and US-born Latinos and non-Latino Whites. This study examined whether the paradox holds after accounting for health care access and utilization.

Methods: The 2019-2020 National Health Interview Survey data were used.

Improving health equity through health care systems research.

Objective: To describe health equity research priorities for health care delivery systems and delineate a research and action agenda that generates evidence-based solutions to persistent racial and ethnic inequities in health outcomes.

Data Sources And Study Setting: This project was conducted as a component of the Agency for Healthcare Research and Quality's (AHRQ) stakeholder engaged process to develop an Equity Agenda and Action Plan to guide priority setting to advance health equity. Recommendations were developed and refined based on expert input, evidence review, and stakeholder engagement.

Undocumented Latino Immigrants and the Latino Health Paradox.

Introduction: Despite having worse healthcare access and other social disadvantages, immigrants have, on average, better health outcomes than U.S.-born individuals.

The Relationship Between Peripheral Arterial Disease Severity and Socioeconomic Status.

Background: Although socioeconomic disparities in outcomes of peripheral artery disease (PAD) have been well studied, little is known about relationship between severity of PAD and socioeconomic status. The objective of this study was to examine this relationship.

Methods: Patients who had operations for severe PAD (rest pain or tissue loss) were identified in the National Inpatient Sample, 2005-2014.

Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.

Objective: To estimate the effects of Children's Health Insurance Reauthorization Act (CHIPRA), a policy that provided states the option to extend Medicaid/CHIP eligibility to immigrant children who have not been legal residents for five years or more, on insurance coverage, access, utilization, and health outcomes among immigrant children.

Data Sources: Restricted use 2000-2016 National Health Interview Survey (NHIS).

Study Design: We used a difference-in-differences design that compared changes in CHIPRA expansion states to changes in non-expansion states.

The impact of Medicaid funding structures on inequities in health care access for Latinos in New York, Florida, and Puerto Rico.

Objective: To study the impact of Medicaid funding structures before and after the implementation of the Affordable Care Act (ACA) on health care access for Latinos in New York (Medicaid expansion), Florida (Medicaid non-expansion), and Puerto Rico (Medicaid block grant).

Data Sources: Pooled state-level data for New York, Florida, and Puerto Rico from the 2011-2019 Behavioral Risk Factor Surveillance System and data from the 2011-2019 American Community Survey and Puerto Rico Community Survey.

Study Design: Cross-sectional study using probit with predicted margins to separately compare four health care access measures among Latinos in New York, Florida, and Puerto Rico (having health insurance coverage, having a personal doctor, delayed care due to cost, and having a routine checkup).

Changes in Coverage and Cost-Related Delays in Care for Latino Individuals After Elimination of the Affordable Care Act's Individual Mandate.

This cross-sectional study examines changes in levels of health care coverage and cost-related delays in care for Latino individuals after elimination of the individual coverage mandate from the Affordable Care Act (ACA).

The Other US Border: Health Insurance Coverage Among Latino Immigrants In Puerto Rico.

Puerto Rico is a US territory and a popular destination for Latino immigrants in the Caribbean. Even with few language and cultural barriers, however, many Latino immigrants in Puerto Rico are uninsured. Using data from the 2014-19 Puerto Rico Community Survey, we examined inequities in health insurance coverage for non-Puerto Rican Latinos ages 18-64 living in Puerto Rico according to citizenship status and Latino subgroup (Dominican, Cuban, Mexican, and other Latino).

The Affordable Care Act and Health Care Access and Utilization Among White, Asian, and Latino Immigrants in California.

Objective: The objective of this study was to examine changes in health care access and utilization for White, Asian, and Latino immigrants associated with the implementation of the Patient Protection and Affordable Care Act (ACA) in California.

Study Design: Using the 2011-2013 and 2015-2017 California Health Interview Survey, we examined changes in 2 health care access and 2 utilization measures among 3 immigrant racial/ethnic groups. We estimated the unadjusted and adjusted percentage point changes in the pre-ACA and post-ACA periods.

Disparities in Health Care Access and Utilization at the Intersections of Urbanicity and Sexual Identity in California.

The aim was to examine differences in health care access at the intersections of urbanicity and sexual identity in California. We used the 2014-2017 Adult California Health Interview Survey paired with the sexual orientation special use research file to create dummy groups representing each dimension of urbanicity and sexual identity to compare access to health care outcomes. We calculated unadjusted proportions and estimated adjusted odds ratios of each dimension relative to urban heterosexual people using logistic regressions.

Changes to Contraceptive Method Use at Title X Clinics Following Delaware Contraceptive Access Now, 2008-2017.

To measure changes in the contraceptive methods used by Title X clients after implementation of Delaware Contraceptive Access Now, a public-private initiative that aims to increase access to contraceptives, particularly long-acting reversible contraceptives (LARCs). Using administrative data from the 2008-2017 Family Planning Annual Reports and a difference-in-differences design, we compared changes in contraceptive method use among adult female Title X family planning clients in Delaware with changes in a set of comparison states. We considered permanent methods, LARCs, moderately effective methods, less effective methods, and no method use.

The Effect of Patient-Centered Communication and Racial Concordant Care on Care Satisfaction Among U.S. Immigrants.

Immigrants living in the United States experience disparities in satisfaction with medical care. Practicing patient-centered communication and providing racially (or race-concordant) concordant care are suggested as effective approaches to improve care satisfaction. Using the Medical Expenditure Panel Survey, we found that immigrant patients with medical providers who practiced patient-centered communication were more likely to be satisfied with the care they received regardless of patient-provider racial concordance, and that simply having racially concordant medical providers did not significantly affect the satisfaction level for immigrant patients.

Insurance Coverage and Health Care Utilization Among Asian Youth Before and After the Affordable Care Act.

Objective: We examined changes in insurance coverage and health care utilization associated with the Affordable Care Act (ACA) among subgroups of Asian youth relative to non-Latino white youth.

Methods: Data were from the 2010 to 2017 American Community Survey and National Health Interview Survey. Difference-in-difference models were used to examine changes in insurance coverage and health care utilization associated with the ACA among subgroups of Asian youth relative to white youth and subgroups of Asian youth in households below 200% of the federal poverty level relative to comparable white youth.

The Effects of the Affordable Care Act on Health Care Access and Utilization Among Asian American Subgroups.

Objectives: We examined changes in health care access and utilization associated with the Patient Protection and Affordable Care Act (ACA) for different Asian American subgroups relative to non-Latino whites (whites).

Research Design: Using 2003-2017 California Health Interview Survey data, we examined changes in 4 health care access measures and 2 utilization measures among whites and 7 Asian American subgroups. We estimated the unadjusted and adjusted percentage point changes on the absolute scale from the pre-ACA to post-ACA periods.

Differences in Health Care Expenditures Among Non-Latino Whites and Asian Subgroups Vary Along the Distribution of the Expenditures.

Using a nationally representative sample from the 2013 to 2016 Medical Expenditure Panel Survey, we examined differences among non-Latino Whites and Asian subgroups (Asian Indians, Chinese, Filipinos, and other Asians) across distributions of total health care expenditures and out-of-pocket (OOP) expenditures. For total health care expenditures, differences between Asian and White adults persisted throughout the distribution, but the magnitude of the difference was larger at no or low levels of expenditures than at high expenditure levels. A similar pattern was observed in OOP expenditures, but the magnitude of the difference was substantially larger at low levels of expenditures.