Immigration, Health Care Access, and Recent Cancer Tests Among Mexican-Americans in California
Immigration, Health Care Access, and Recent Cancer Tests Among Mexican-Americans in California
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DOI：
10.1007/s10903-008-9198-3
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发表时间：
2010-08-01
影响因子：
1.9
通讯作者：
Meissner, Helen I.
中科院分区：
文献类型：
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作者：
Breen, Nancy;Rao, Sowmya R.;Meissner, Helen I.
移民的癌症检测率较低可能是由于缺乏流利的英语和其他技能以及有关导航美国医疗保健市场的知识，缺乏获得医疗服务的机会，或两者兼而有之。我们分析了2001年加州健康访谈调查（CHIS）的9,079名墨西哥裔美国人受访者，这些受访者分为在美国出生、在美国生活10年或10年以上或在美国生活不到10年。CHIS提供了美国调查中最大的墨西哥裔美国人样本。获得保健意味着有医疗保险和通常的保健来源。英语熟练程度意味着受访者以英语接受采访。多因素Logistic回归分析用于预测结局。在美国居住时间较长的受访者更有可能报告获得医疗服务和接受癌症筛查检查。无论在美国居住时间如何，报告获得医疗服务的受访者的检查率相似。回归结果表明，在美国的时间和主要语言相对于使用癌症筛查测试并不显着，但获得护理。加州的乳腺癌和宫颈癌早期检测项目“每个妇女都有责任”所涵盖的癌症筛查测试，与该项目所不涵盖的结直肠癌筛查相比，各组之间的差距较小。加州是唯一一个有调查能够监测小人口群体变化的州。了解亚组特有的障碍是制定适当政策和干预措施以增加癌症筛查检查使用的关键。
Immigrants' lower rates of cancer testing may be due to lack of fluency in English and other skills and knowledge about navigating US health care markets, lack of access to health services, or both. We analyzed 9,079 Mexican-American respondents to the 2001 California Health Interview Survey (CHIS) grouped as born in the US, living in the US 10 or more years, or living in the US less than 10 years. The CHIS provides the largest Mexican-American sample in a US survey. Access to care meant having health insurance coverage and a usual source of care. English proficiency meant the respondent took the interview in English. Multivariate logistic regression was used to predict outcomes. Respondents reporting more time in the US were more likely to report access to medical care and to report getting a cancer screening exam. Regardless of time in the US, respondents reporting access had similar test rates. Regression results indicate that time in the US and primary language were not significant relative to use of cancer screening tests, but access to care was. Cancer screening tests that are covered by Every Woman Counts, California's breast and cervical cancer early detection program, had smaller gaps among groups than colorectal cancer screening which is not covered by a program. California is the only state with a survey able to monitor changes in small population groups. Understanding barriers specific to subgroups is key to developing appropriate policy and interventions to increase use of cancer screening exams.