Association of Maternal Citizenship and State-Level Immigrant Policies With Health Insurance Coverage Among US-Born Latino Youths.
Association of Maternal Citizenship and State-Level Immigrant Policies With Health Insurance Coverage Among US-Born Latino Youths.
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DOI：
10.1001/jamanetworkopen.2020.21876
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发表时间：
2020-10-01
影响因子：
13.8
通讯作者：
Stimpson JP
中科院分区：
文献类型：
--
作者：
Alberto CK;Kemmick Pintor J;Young ME;Tabb LP;Martínez-Donate A;Langellier BA;Stimpson JP
这项横断面研究使用美国社区调查的数据，以研究国家一级的移民融合和刑事定罪政策和母亲的公民身份与美国出生的拉丁裔青年的医疗保险覆盖范围之间的关联。是否国家一级的政策，融合或刑事定罪的移民与差距，在青年健康保险覆盖面的母亲公民身份？在这项对226691名美国出生的拉丁裔青年的横断面研究中，居住在移民融合政策水平较低和移民刑事定罪政策水平较高的州与较高的无保险率相关。对于那些居住在低融合和高刑事化移民政策的州的人来说，非美国公民母亲的年轻人的不保险率更高。州一级的移民政策可能与美国出生的拉丁裔青年基于母亲的公民身份获得医疗保健，这些差异的认识似乎需要告知宣传工作。州一级的移民政策与拉丁美洲青年的不保险之间的关联仍然未知。评估美国出生的拉丁裔青年母亲公民身份的国家一级移民融合和刑事定罪政策与医疗保险覆盖范围之间的关联。这项横断面研究分析了2016年1月1日至2018年12月31日美国社区调查的二手数据，针对美国出生的拉丁裔青年（年龄≤17岁）及其母亲（年龄18-64岁），以及移民融合和刑事定罪政策的州级指标（所有50个州和哥伦比亚特区）。移民融合和刑事定罪政策。主要结果是母亲报告的青年不保险状态时，美国社区调查采访。研究了青年不保险的母亲的公民身份，国家移民融合政策的背景下，和国家移民刑事定罪政策的背景下的变化。所有分析均采用加权调查数据进行。在纳入研究的226691名美国出生的拉丁裔青年（115431名[50.92%]男性;平均[SD]年龄为7.66 [4.92]岁）中，36.64%（95%CI，36.21%-36.92%）的母亲为非公民。总体而言，7.09%（95%CI，6.78%-7.41%）的非公民母亲报告说，她们的年轻人没有保险，而公民母亲的比例为4.68%（95%CI，4.49%-4.88%）。居住在移民融合政策水平较低的州的无保险青年中，（8.22%~ 10.06%）的母亲为外地人，4.75%的（95%CI，4.19%~ 5.37%）母亲为市民;居住在犯罪率高的州的无保险青年中，9.37%（95% CI，8.90%~ 9.87%）为非公民母亲，5.91%（95% CI，5.64%~ 6.20%）为公民母亲。在移民融合政策较少的州，母亲为非公民的年轻人不保险的概率比母亲为公民的年轻人高3.3%（95%CI，2.3%-4.4%）。在非公民母亲的青年中，居住在移民融合政策水平低与水平高的州之间的不保险概率差异为2.1%（95%CI，0.6%-3.6%）。居住在移民刑事定罪政策水平高的州的年轻人中，与母亲是公民的人相比，母亲是非公民的人没有保险的可能性高2.6%（95%CI，1.9%-3.0%）。在非公民母亲的青少年中，居住在移民刑事定罪政策水平低的州与移民刑事定罪政策水平高的州之间的不保险概率差异为1.7%（95%CI，0.7%-2.7%）。这项横断面研究的结果表明，在美国出生的拉丁裔青年，产妇公民身份的不保险的差距与国家一级的移民融合和刑事定罪政策，反移民政策可能与美国出生的拉丁裔青年在医疗保健方面的差距。
This cross-sectional study uses data from the American Community Survey to examine the association of state-level immigrant integration and criminalization policies and maternal citizenship status with health insurance coverage among US-born Latino youths. Are state-level policies that integrate or criminalize immigrants associated with disparities in youth health insurance coverage by maternal citizenship status? In this cross-sectional study of 226 691 US-born Latino youths, residing in a state with a lower level of immigrant integration policies and a higher level of immigrant criminalization policies was associated with higher uninsurance rates. Uninsurance rates for youths with non–US citizen mothers were higher for those who resided in states with low integration and high criminalization immigrant policies. State-level immigrant policies may be associated with health care access among US-born Latino youths based on maternal citizenship status, and awareness of these disparities appears to be needed to inform advocacy efforts. The association of state-level immigrant policies with uninsurance among Latino youths remains unknown. To assess the association of state-level immigrant integration and criminalization policies with health insurance coverage among US-born Latino youths by maternal citizenship. This cross-sectional study analyzed secondary data from the American Community Survey, January 1, 2016, to December 31, 2018, for US-born Latino youths (age, ≤17 years) and their mothers (age, 18-64 years) as well as state-level indicators of immigrant integration and criminalization policies (in all 50 states and the District of Columbia). Immigrant integration and criminalization policies. The main outcome was maternal reports of youth uninsurance status at the time of the American Community Survey interview. Variation in youth uninsurance by maternal citizenship, state immigrant integration policy context, and state immigrant criminalization policy context were examined. All analyses were conducted with weighted survey data. Of the 226 691 US-born Latino youths (115 431 [50.92%] male; mean [SD] age, 7.66 [4.92] years) included in the study, 36.64% (95% CI, 36.21%-36.92%) had noncitizen mothers. Overall, 7.09% (95% CI, 6.78%-7.41%) of noncitizen mothers reported that their youths were uninsured compared with 4.68% (95% CI, 4.49%-4.88%) of citizen mothers. Of uninsured youths who resided in states with a low level of immigrant integration policies, 9.10% (8.22%-10.06%) had noncitizen mothers and 4.75% (95% CI, 4.19%-5.37%) had citizen mothers; of uninsured youths who resided in states with high criminalization policies, 9.37% (95% CI, 8.90%-9.87%) had noncitizen mothers and 5.91% (95% CI, 5.64%-6.20%) had citizen mothers. In states with few immigrant integration policies, the probability of uninsurance among youths with noncitizen mothers was 3.3% (95% CI, 2.3%-4.4%) higher than that among youths with citizen mothers. Among youths with noncitizen mothers, the difference in the probability of uninsurance between those residing in states with a low level vs a high level of immigrant integration policies was 2.1% (95% CI, 0.6%-3.6%). Among youths residing in states with high levels of immigrant criminalization policies, those with noncitizen mothers had a 2.6% (95% CI, 1.9%-3.0%) higher probability of being uninsured compared with those whose mothers were citizens. Among youths with noncitizen mothers, the difference in the probability of uninsurance between those who resided in a state with a low level vs a state with a high level of immigrant criminalization policies was 1.7% (95% CI, 0.7%-2.7%). The findings of this cross-sectional study suggest that among US-born Latino youths, disparities in uninsurance by maternal citizenship are associated with state-level immigrant integration and criminalization policies and that anti-immigrant policies may be associated with disparities in health care access for US-born Latino youths.
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