Columbia University, Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY, USA.
Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, USA.
Soc Sci Med. 2018 Dec;219:54-60. doi: 10.1016/j.socscimed.2018.10.014. Epub 2018 Oct 19.
Although the reasons for immigrating to the U.S. vary by Latino groups, many Latinos cite economic or political motivations for their migration. Once in the United States, Latino immigrants may face many challenges, including discrimination and blocked opportunities for social mobility, and difficulties in obtaining health services and quality health care. The purpose of this study was to explore how changes in social mobility from the country of origin to the U.S. may relate to Latina women's health care interactions. We examined whether self-reported social mobility among 419 Latina women immigrants is associated with satisfaction with health care. We also examined the association among social mobility and self-rated health, quality of care, and medical mistrust. Upward social mobility was associated with greater number of years lived in the U.S., and downward social mobility was associated with more years of education. Those who reported no changes in social class (stable social mobility) were older and were the most satisfied with their medical care. Multiple regression analyses indicated that downward social mobility was associated with less satisfaction with care when controlling for demographic covariates, quality of care, and medical mistrust. Results suggest that perceived social mobility may differentially predict Latina immigrants' satisfaction with the health care system, including their trust in U.S. medical institutions. We conclude that perceived social mobility is an important element in exploring the experiences of immigrant Latinas with health care in the United States.
尽管拉丁裔群体移民美国的原因各不相同,但许多拉丁裔人将经济或政治动机作为其移民的原因。一旦到达美国,拉丁裔移民可能会面临许多挑战,包括歧视和社会流动机会受阻,以及获得医疗服务和优质医疗保健的困难。本研究旨在探讨原籍国到美国的社会流动变化如何与拉丁裔妇女的医疗保健互动相关。我们考察了 419 名拉丁裔女性移民中自我报告的社会流动性是否与对医疗保健的满意度相关。我们还研究了社会流动性与自我评估的健康状况、护理质量和医疗不信任之间的关联。向上的社会流动性与在美国生活的年数增加有关,而向下的社会流动性与受教育年限增加有关。那些报告社会阶层没有变化(稳定的社会流动性)的人年龄更大,对他们的医疗保健最满意。多元回归分析表明,在控制人口统计学协变量、护理质量和医疗不信任的情况下,社会地位下降与对护理的满意度降低有关。研究结果表明,感知到的社会流动性可能会对拉丁裔移民对医疗保健系统的满意度产生差异预测,包括他们对美国医疗机构的信任。我们得出结论,感知到的社会流动性是探索移民拉丁裔在美国的医疗保健体验的一个重要因素。