Medical care use by Mexican-Americans: evidence from the human population laboratory studies

Data are presented from sample surveys conducted in 1974 (N = 3,119) and 1975 (N = 657) in Alameda County, California, by the Human Population Laboratory. Mexican-Americans are compared to Anglos and blacks in terms of physician visits, dental examinations, general physical examinations, and eye examinations. Comparison of crude percentages indicates that there is very little ethnic variation in either sample regarding regular source of medical care or health insurance coverage, although the trend is for fewer Chicanos to have such coverage. In terms of physician visits, there is little difference between Anglos and Chicanos. By contrast, fewer Chicanos and blacks report dental examinations in the past year (Chicanos have the lowest rate). Fewer Chicanos report a general medical examination in the past year and more report never having had a medical checkup. Likewise, more Chicanos report never having an eye examination while relatively fewer report such an exam in the past year. Controlling for the effects of age, sex, education, family income, health insurance, regular source of care, physical health status and perceived health reduces differences in rate of physician visits among the ethnic groups, primarily by reducing the rate for blacks and increasing the rate for Chicanos. Likewise, adjustment for all 8 factors reduces ethnic differences in general medical examination rates, in this case by increasing the rates for the minority groups. Adjustment reduces the ethnic differences in dental examination rates by increasing the minority group rates, but large differences still remain. For eye examinations, adjustment has little effect on the rates for Anglos and blacks, but substantially increases the rate for Chicanos. For all 4 types of medical care behavior, controlling for the effects of education and family income (so-called inequitable reasons for lower access to care) consistently produces the greatest effect, particularly for Chicanos. In each case, the effect is to create greater parity between Chicanos and Anglos by increasing the utilization rate for Chicanos. However, even after adjustment, the rate for Chicanos remains lower.