State Health Service Eligibility, Community Clinics and Regular Physician Care for Children of Mexican Immigrants

Deborah Roempke Graefe, Pennsylvania State University
Gordon F. De Jong, Pennsylvania State University
Stephanie Howe, Pennsylvania State University

Immigrant-destination contextual impacts on health care utilization are examined as salient research scholarship and public policy issues for the health of Mexican immigrant children. We evaluate the effects of state policies regarding health service eligibility and availability of community health clinics on regular physician care in new and traditional immigrant destination areas. State-level data on Child Health Insurance Program services for immigrant children and county-level data on availability of health clinics are integrated with individual-level, nationally representative health care data from the 1996-1999 and 2001-2003 panels of the Survey of Income and Program Participation. Utilizing multi-level regression, we model the impact of these state political and health care contexts on physician utilization patterns, conditioned on child's health status and insurance coverage and family human capital and demographic characteristics. Results document key interactions between contextual factors and child and family characteristics for identifying children most at-risk for no regular physician care.