Young Maria-Elena De Trinidad, Leon-Perez Gabriela, Wells Christine R, Wallace Steven P
Department of Community Health Sciences, Fielding School of Public Health, University of California , Los Angeles , CA , USA.
Department of Sociology, Vanderbilt University , Nashville , TN , USA.
Ethn Health. 2019 Nov;24(8):960-972. doi: 10.1080/13557858.2017.1390074. Epub 2017 Oct 20.
Policy-making related to immigrant populations is increasingly conducted at the state-level. State policy contexts may influence health insurance coverage by determining noncitizens' access to social and economic resources and shaping social environments. Using nationally representative data, we investigate the relationship between level of inclusion of state immigrant policies and health insurance coverage and its variation by citizenship and race/ethnicity. Data included a measure of level of inclusion of the state policy context from a scan of 10 policies enacted prior to 2014 and data for adults ages 18-64 from the 2014 American Community Survey. A fixed-effects logistic regression model tested the association between having health insurance and the interaction of level of inclusiveness, citizenship, and race/ethnicity, controlling for state- and individual-level characteristics. Latino noncitizens experienced higher rates of being insured in states with higher levels of inclusion, while Asian/Pacific Islander noncitizens experienced lower levels. The level of inclusion was not associated with differences in insurance coverage among noncitizen Whites and Blacks. Contexts with more inclusive immigrant policies may have the most benefit for Latino noncitizens.
与移民群体相关的政策制定越来越多地在州一级进行。州政策环境可能会通过决定非公民获得社会和经济资源的机会以及塑造社会环境来影响医疗保险覆盖范围。利用具有全国代表性的数据,我们研究了州移民政策的包容程度与医疗保险覆盖范围之间的关系,以及这种关系在公民身份和种族/族裔方面的差异。数据包括对2014年之前颁布的10项政策进行扫描得出的州政策环境包容程度的衡量指标,以及2014年美国社区调查中18至64岁成年人的数据。一个固定效应逻辑回归模型检验了拥有医疗保险与包容程度、公民身份和种族/族裔之间的相互作用之间的关联,并控制了州和个人层面的特征。在包容程度较高的州,拉丁裔非公民的参保率较高,而亚太岛民非公民的参保率较低。包容程度与非公民白人和黑人在保险覆盖范围上的差异无关。移民政策更具包容性的环境可能对拉丁裔非公民最有益。