Special Populations
American Journal of Public Health
"Health Status and Health Service Access and Use Among Children in U.S. Immigrant Families"
Parents' citizenship status in the U.S. could significantly impact children's access to health care, as children born in the U.S. to noncitizen parents face similar barriers to care as foreign-born children residing in the U.S., the study found.
Researchers analyzed heath insurance status and health services data from 1999 on three subgroups of immigrant children:
- Foreign-born children with noncitizen parents;
- Foreign-born children who were naturalized citizens; and
- U.S.-born children with noncitizen parents.
Noncitizen and naturalized families might avoid using public health programs including SCHIP and Medicaid because of legal restrictions, language barriers and fear that using the health system could expose or jeopardize their immigrant status, according to researchers.
The researchers recommended increased outreach to encourage immigrant families to enroll their children in public health insurance programs, when they are eligible, and more emphasis on preventive health and dental services. Such initiatives should involve education about access to care, as well as culturally sensitive services and language assistance. In addition, an amendment to the Immigrant Children's Health Improvement Act should be enacted to restore health insurance coverage to legal immigrant children and pregnant women.
The study was conducted by researchers from:
- Children's National Medical Center;
- Health Resources and Services Administration; and
- Maternal and Child Health Information Resource Center (Huang et al., American Journal of Public Health, April 2006).
American Journal of Public Health
"Understanding Health Disparities: The Role of Race and Socioeconomic Status in Children's Health"
The association of socioeconomic status, as measured by a parent's education level, and children's health problems is most evident among white and black populations.
Researchers analyzed health data from 1994 on children ages 18 and younger to determine the effects of race and socioeconomic factors on children's health.
The analysis found that poor overall health, activity and school limitations, and chronic circulatory conditions were more prevalent in children whose parents had lower education levels. The relationship was strongest among white and black children, and weaker or nonexistent among Latino or Asian children.
By better understanding the factors that lessen the impact of low parental education levels on children's health, such as the role of social networks, techniques could be developed to improve the health of other low socioeconomic status children at an early age, according to researchers. The results of the analysis also indicate that efforts to eliminate socioeconomic health disparities could be more effective by targeting specific racial or ethnic populations.
The analysis was conducted by researchers from:
- University of British Columbia, Vancouver;
- Washington University in St. Louis; and
- University of Pittsburgh School of Medicine (Chen et al., American Journal of Public Health, April 2006).
The Milbank Quarterly
"The Need for More Research on Language Barriers in Health Care: A Proposed Research Agenda"
Because the number of Americans who report low English-language proficiency is growing, more research is needed to determine the effects of language barriers in health care, as well as to develop plans to address the problem and determine the effectiveness of those plans, researchers said.
According to researchers, patients who describe themselves as having limited English skills are:
- Less likely to receive proper care;
- Less likely to understand the care they receive;
- Less likely to receive recommended follow-up care;
- More likely to be hospitalized, and for longer periods; and
- Less satisfied with their health care experiences.
Researchers note that care providers also report less overall satisfaction in interactions with patients whose English skills are limited.
The report suggests that findings from previous studies deserve further analysis to control for other factors, such as age, gender and level of English ability. Studies also should focus on the effectiveness of language assistance services and the costs associated with language barriers and efforts to reduce the barriers. Researchers note that further studies could result in more effective and accessible language assistance services for limited- and non-English speakers.
The report was written by researchers from:
- John H. Stroger Jr. Hospital and Rush University Hospital, Chicago;
- University of California-San Francisco; and
- Royal Roads University, Victoria, B.C., Canada (Jacobs et al., The Milbank Quarterly, Q1 2006).
American Journal of Public Health
"An Ecological Study of Tuberculosis Transmission in California"
Pediatric tuberculosis rates in California communities indicate that race and ethnicity data are more accurate indicators of tuberculosis risk than socioeconomic risk factors, including education level, unemployment rates and population density, as suggested by previous studies, researchers said.
Researchers compared ecological factors with rates of tuberculosis throughout the state, using pediatric cases as an indicator of new transmission.
Using specific ecological data from geographically grouping addresses from reported tuberculosis cases and linking that data to specific geographical locations such as census tracts can help state and local tuberculosis control program identify at-risk populations that could benefit from increased disease surveillance, researchers concluded.
The analysis was conducted by researchers from:
- Boston Medical Center;
- California Department of Health Services; and
- University of California-Berkeley (Myers et al., American Journal of Public Health, April 2006).