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未参保移民:墨西哥归国移民的医疗保险覆盖情况及医疗服务可及性

Uninsured Migrants: Health Insurance Coverage and Access to Care Among Mexican Return Migrants.

作者信息

Wassink Joshua

机构信息

University of North Carolina at Chapel Hill, Department of Sociology and Carolina Population Center.

出版信息

Demogr Res. 2018;38. doi: 10.4054/DemRes.2018.38.17. Epub 2018 Jan 30.

Abstract

BACKGROUND

Despite an expansive body of research on health and access to medical care among Mexican immigrants in the United States, research on return migrants focuses primarily on their labor market mobility and contributions to local development.

OBJECTIVE

Motivated by recent scholarship that documents poor mental and physical health among Mexican return migrants, this study investigates return migrants' health insurance coverage and access to medical care.

METHODS

I use descriptive and multivariate techniques to analyze data from the 2009 and 2014 rounds of Mexico's National Survey of Demographic Dynamics (ENADID, combined n=632,678).

RESULTS

Analyses reveal a large and persistent gap between recent return migrants and non-migrants, despite rising overall health coverage in Mexico. Multivariate analyses suggest that unemployment among recent arrivals contributes to their lack of insurance. Relative to non-migrants, recently returned migrants rely disproportionately on private clinics, pharmacies, self-medication, or have no regular source of care. Mediation analysis suggests that returnees' high rate of uninsurance contributes to their inadequate access to care.

CONCLUSION

This study reveals limited access to medical care among the growing population of Mexican return migrants, highlighting the need for targeted policies to facilitate successful reintegration and ensure access to vital resources such as health care.

摘要

背景

尽管针对美国墨西哥移民的健康状况及医疗服务可及性已有大量研究,但关于回流移民的研究主要集中在其劳动力市场流动性及对当地发展的贡献上。

目的

鉴于近期有学术研究表明墨西哥回流移民的身心健康状况不佳,本研究调查回流移民的医疗保险覆盖情况及医疗服务可及性。

方法

我运用描述性和多变量分析技术,对2009年和2014年两轮墨西哥人口动态国家调查(ENADID,合并样本量n = 632,678)的数据进行分析。

结果

分析显示,尽管墨西哥的整体医保覆盖率有所上升,但近期回流移民与非移民之间仍存在巨大且持续的差距。多变量分析表明,新抵达者中的失业现象导致他们缺乏保险。与非移民相比,近期回流移民过度依赖私人诊所、药店和自我药疗,或者没有固定的医疗服务来源。中介分析表明,回流者的高未参保率导致他们获得医疗服务的机会不足。

结论

本研究揭示了墨西哥回流移民这一不断增长的群体在医疗服务可及性方面存在限制,凸显了制定针对性政策以促进其成功重新融入并确保获得诸如医疗保健等重要资源的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d8/5894520/d8789ad98224/nihms948523f1.jpg

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