RAND researchers offer options to improve immigrant health care quali...( Expanding opportunities for immigran...),Health

Expanding opportunities for immigrants to obtain legal residency and citizenship may be the best option to offer them better access to health care, according to an article published today by the RAND Corporation in the journal Health Affairs.

Immigrants now make up 12 percent of the U.S. population, said Kathryn Pitkin Derose, the lead author of the article and a policy researcher at RAND, a nonprofit research organization. Ultimately, the health of this large segment of our population will affect the health of the nation.

The article from RAND Health, Immigrants and Health Care: Sources of Vulnerability, appears in a special issue of Health Affairs that looks at a how to improve healthcare for vulnerable populations.

The researchers note that immigrants vary on numerous factors that affect their access to, and quality of, health care. Those factors include: socioeconomic background, immigration status, limited English proficiency, residential location, and stigma and marginalization.

For example, previous studies have found that while immigrants have lower rates of health insurance coverage than native-born residents, 65 percent of undocumented immigrants are uninsured, compared to 15 to 20 percent of naturalized citizens.

Further, although limited English proficiency is related to poorer access to and lower quality of health care, what language is spoken may be an intervening factor. For example, the researchers cite a previous study that found that among those with limited-English proficiency, Spanish-speaking women in California were more likely to receive a Pap test over a three-year period, compared to women who spoke Vietnamese, Cantonese, Mandarin or Korean.

And while immigrants overall are less likely than native-born citizens to have graduated from high school and are more likely to work in low-paying occupations, there are striking variations among immigrant subgroups. The proportion of As
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