Access to and utilization of health care by subgroups of Latino children.

BACKGROUND: Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino children.

OBJECTIVES: To delineate differences in access and utilization patterns between white and subgroups of Latino children, after adjusting for important predisposing, enabling, and need factors.

RESEARCH DESIGN: National Health Interview Survey data (1998-2006) were used to study children of Mexican, Puerto Rican, Cuban, and other Latino ancestry, as well as white children. Data were adjusted for predisposing, enabling, and need factors in incremental models. Additional analyses were conducted to test for effect modification of health insurance and language use on the associations between the subgroups and health care access and utilization.

RESULTS: Children of Mexican ancestry were found to have the most consistent pattern of poorer access to health care and use of services compared with the other subgroups. Multivariate analyses demonstrated persistent variability between Latino subgroups. Adjustment for predisposing, enabling, and need factors did not fully explain subgroup differences.

CONCLUSIONS: Efforts to understand health care services for Latino children will require further examination of specific subgroups, and interventions to improve access and utilization should not be limited to health insurance coverage and language services.