Access to Health Care for Nonmetro and Metro Latinos of Mexican Origin in the United States

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Abstract
Background: A growing number of Latinos are moving to nonmetro areas, but little research has examined how this trend might affect the Latino-disadvantage in access to healthcare. Objective: We investigate health care access disparities between non-Latino whites and Latinos of Mexican origin, and whether the disparities differ between metro and nonmetro areas. Methods: A series of logistic regression models provide insight on whether individuals have a usual source of care and whether they have had any physician visits in the past year. Our analyses focus on the interaction between Mexican origin descent and nonmetro residence. Subjects: Nationally representative data from the 2002–2003 Medical Expenditure Panel Survey are analyzed. The sample consists of working-aged adults age 18–64, yielding a sample size of 29,875. Results: The Mexican disadvantage in having a usual source of care is much greater among nonmetro residents than among those living in metro areas. The Mexican disadvantage in the likelihood of seeing a physician at least 1 time during the year does not differ across locations. Although general and ethnicity-specific predictors explain the disadvantage of Mexicans in having a usual source of care, they do not explain the added disadvantage of being Mexican and living in nonmetro areas. Conclusions: This study identifies a new challenge to the goal of eliminating health care disparities in the United States. The Latino population living in nonmetro areas is growing, and our findings suggest that Latinos in nonmetro areas face barriers to having a usual source of care that are greater than those faced by Latinos in other areas.