Dornsife School of Public Health, Drexel University, 3600 Market St, Philadelphia, PA, 19104, USA.
Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, Nesbitt Hall, Philadelphia, PA, 19104, USA.
BMC Public Health. 2020 Jul 11;20(1):1088. doi: 10.1186/s12889-020-09188-1.
Disparities in access to care persist for Latino youth born in the United States (US). The association of maternal characteristics, such as maternal citizenship status and insurance coverage, on youth health insurance coverage is unclear and is important to examine given the recent sociopolitical shifts occurring in the US.
We analyzed pooled cross-sectional data from the 2010-2018 National Health Interview Survey to examine the association of Latina maternal citizenship status on maternal insurance coverage status and youth uninsurance among US-born Latino youth. Our study sample consisted of 15,912 US-born Latino youth (ages < 18) with linked mothers. Our outcome measures were maternal insurance coverage type and youth uninsurance and primary predictor was maternal citizenship status. Generalized structural equation modeling was used to examine the relationships between maternal characteristics (maternal citizenship, maternal insurance coverage status) and youth uninsurance.
Overall, 7% of US-born Latino youth were uninsured. Just 6% of youth with US-born mothers were uninsured compared to almost 10% of those with noncitizen mothers. Over 18% of youth with uninsured mothers were uninsured compared to 2.2% among youth with mothers who had private insurance coverage. Compared to both US-born and naturalized citizen Latina mothers, noncitizen Latina mothers had 4.75 times the odds of reporting being uninsured. Once adjusted for predisposing, enabling, and need factors, maternal uninsurance was strongly associated with youth uninsurance and maternal citizenship was weakly associated with youth uninsurance among US-born Latino youth.
Maternal citizenship was associated with both maternal uninsurance and youth uninsurance among US-born Latino youth. Federal- and state-level health policymaking should apply a two-generational approach to ensure that mothers of children are offered affordable health insurance coverage, regardless of their citizenship status, thus reducing uninsurance among US-born Latino youth.
在美国出生的拉丁裔青年在获得医疗服务方面仍然存在差异。母亲的特征（如公民身份和保险覆盖范围）与青年医疗保险覆盖范围之间的关联尚不清楚，鉴于美国最近发生的社会政治变化，这一点很重要。
我们分析了 2010-2018 年全国健康访谈调查的汇总横断面数据，以研究拉丁裔母亲的公民身份对母亲保险覆盖状况和美国出生的拉丁裔青年中青少年未保险的影响。我们的研究样本包括 15912 名有母亲关联的美国出生的拉丁裔青年（年龄<18 岁）。我们的结局指标是母亲的保险覆盖类型和青年未保险情况，主要预测指标是母亲的公民身份。广义结构方程模型用于研究母亲特征（母亲公民身份、母亲保险覆盖状况）与青年未保险之间的关系。
总体而言，7%的美国出生的拉丁裔青年没有保险。只有 6%的美国出生的青年没有保险，而没有公民身份的母亲的子女中几乎有 10%没有保险。与母亲有私人保险的青年相比，18%以上没有保险的母亲的子女没有保险，而母亲有私人保险的青年中，只有 2.2%的青年没有保险。与美国出生和入籍的拉丁裔母亲相比，非公民拉丁裔母亲报告没有保险的可能性是前者的 4.75 倍。在调整了倾向因素、促成因素和需求因素后，母亲没有保险与青年没有保险密切相关，而母亲的公民身份与美国出生的拉丁裔青年的青年没有保险之间的关联较弱。
在美出生的拉丁裔青年中，母亲的公民身份与母亲和青年的保险范围均有关。联邦和州一级的卫生政策制定应采取两代人方法，确保儿童的母亲获得负担得起的医疗保险，无论其公民身份如何，从而减少美国出生的拉丁裔青年中的未保险人数。
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