The effect of immigration status on racial differences in health insurance coverage, access to care, and utilization in the United States

Background. Lack of coverage, lack of access, and failure to utilize health care services have all been linked to dismal health outcomes in the US. Such consequences have been a longstanding challenge that US minorities are faced with, in the context of a health care system believed to be lacking efficiency and equity. National population surveys in the US suggest that the number of uninsured approaches 50 millions, while some concerns and suspicions are raised by opponents to the growing number of foreign born US residents, many of whom are Hispanic. Research shows that race is a significant predictor of lack of coverage, access, and utilization, while age, gender, education, and income are also linked to these outcomes. We investigated the potential effect of immigration status or duration in the US on the association between coverage, access, use, and race. Methods. Using National Health Interview Survey (NHIS) data of 2006, we selected 22, 667 individuals of Non-Hispanic Black, Hispanic, and Non-Hispanic White descent, at least 18 years of age, US-born and foreign-born who reported their duration of residence in the US. Through complex sample survey logistic regression analysis, we computed odds ratios, beta coefficients, and 95% confidence intervals using models which excluded then included immigration status. Results. Although a significant predictor of the outcomes, immigration status did not change the relationship between each of the dependent variables (coverage, access, utilization), and the factor race, while adjusting for age, gender, education, and income. Our results show that Hispanics were least likely to have coverage (OR=.58; 95% CI[.49, .68]), access (OR=.62; 95% CI[.50, .76]), and to utilize services (OR=.60; 95% CI[.46, .79]) followed by Non-Hispanic Blacks, and Non-Hispanic Whites. These results were not changed by stratification, or the inclusion of interaction terms to eliminate the potential effect of relationships between independent variables. Recent immigrants (<5 years in US) were 0.12 times less likely to be insured, but also 0.26 times less likely to utilize services (p<0.001), and in addition they represented only 7.3% of the uninsured and 1.9% of the US population in 2006. Furthermore, 12% of the Non-Hispanic White population in the US was not covered, and 65% of the uninsured individuals were US-Born Citizens. Other predictors of lack of coverage, access and use were age below 45, male gender, education at high school or below, and income of less than $20,000. Conclusion. This investigation shows that the high percentage of uninsured was not directly caused by Hispanics, and immigration status alone could not explain racial differences in coverage, access, and utilization. An immigration reform may not be the solution to the healthcare crisis, and more specifically, will not stop the increase in the number of uninsured in the US, nor reduce the cost of health care. As a better alternative, universal health insu rance coverage should be considered, when aiming to eliminate racial disparities, and to solve the health care crisis. ^ Keywords. health insurance, coverage, access, utilization, race, immigration, disparities.^

Mapping the literature of cytotechnology

The major purpose of this study was to identify and assess indexing coverage of core journals in cytotechnology. It was part of a larger project sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association to map the literature of allied health. Three representative journals in cytotechnology were selected and subjected to citation analysis to determine what journals, other publication types, and years were cited and how often. Bradford's Law of Scattering was applied to the resulting list of cited journals to identify core titles in the discipline, and five indexes were searched to assess coverage of these core titles. Results indicated that the cytotechnology journal literature had a small core but wide dispersion: one third of the 21,021 journal citations appeared in only 3 titles; another third appeared in an additional 26 titles; the remaining third were scattered in 1,069 different titles. Science Citation Index Expanded rated highest in indexing coverage of the core titles, followed by MEDLINE, EMBASE/Excerpta Medica, HealthSTAR, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The study's results also showed that journals were the predominantly cited format and that citing authors relied strongly on more recent literature.

A bibliography of the dialect literature of Cumberland and Westmorland, and Lancashire North-of-the-Sands.

Mode of access: Internet.

An introduction to the literature of the New Testament /

Includes bibliographical references and indexes.

Dental bibliography ... literature of dental science and art as found in the libraries of the New York academy of medicine and Bernhard Wolf Weinberger,

[pt. I.] A reference index.--pt. II. A subject index, with additional reference index.

Implementation of immigration reform [microform] : hearing before the Subcommittee on Immigration and Refugee Affairs of the Committee on the Judiciary, United States Senate, One Hundredth Congress, second session on the implementation of the Immigration Reform and Control Act, April 14, 1988.

"Serial no. J-100-60."

The literature of the nineteenth of April, 1775-1875.

Mode of access: Internet.

The Literature of refrigeration /

Mode of access: Internet.

The literature of geology

Mode of access: Internet.

A bibliographical manual for students of the language and literature of England and the United States; a short-title list.

"The province of English philology [by] Albert Stanburrough Cook": p. 253-269.

A bibliography of the research in tissue culture, 1884 to 1950; an index to the literature of the living cell cultivated in vitro. Supplementary author list, 1950- (Incomplete and unverified, October 1953)

Cover title.

Engineering abstracts from the current periodical literature of engineering and applied science, published outside the United Kingdom.

No. 26 and 27 issued in combined form.

Horæ sinicæ: translations from the popular literature of the Chinese.

San-tsi-king: the three-character classic; on the utility and honour of learning.--Ta-hio; the great science.--Account of Foe, the deified founder of a Chinese sect.--Extract from the Ho-kiang.--Account of the sect. Tao-szu.--Dissuasive from feeding on beef.--Specimens of Chinese epistolary correspondence.

Selected literature of soybean entomology /

Includes bibliographies.

A guide to the law and legal literature of Bolivia.

Mode of access: Internet.