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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.114447v1 98/11/1987    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bastida, E. Articles by Pagán, J. A. Search for Related Content PubMed PubMed Citation Articles by Bastida, E. Articles by Pagán, J. A. Related Collections Community Health Geography Insurance Health Policy Access to Care Hispanics/Latinos Socioeconomic Factors

Elena Bastida, PhD, H. Shelton Brown, III, PhD and José A. Pagán, PhD

Elena Bastida is with the Center on Aging and Health and the Department of Sociology, University of Texas–Pan American, Edinburg. H. Shelton Brown III is with the Health Economics Division of Management, Policy and Community Health, Michael & Susan Dell Center for Advancement of Healthy Living Institute for Health Policy, University of Texas School of Public Health, Austin. José A. Pagán is with the Institute for Health Policy and the Department of Health Economics, University of Texas Pan American, Edinburg.

Correspondence: Requests for reprints should be sent to Elena Bastida, PhD, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort North, TX 76107 (e-mail: bastida{at}hsc.unt.edu).

Objectives. We examined disparities in health care use among US–Mexico border residents, with a focus on the unique binational environment of the region, to determine factors that may influence health care use in Mexico.

Methods. Data were from 2 waves of a population-based study of 1048 Latino residents of selected Texas border counties. Logistic regression models examined predictors of health insurance coverage. Results from these models were used to examine regional patterns of health care use.

Results. Of the respondents younger than 65 years, 60% reported no health insurance coverage. The uninsured were 7 and 3 times more likely in waves 3 and 4, respectively, to use medical care in Mexico than were the insured. Preference for medical care in Mexico was an important predictor.

Conclusions. For those who were chronically ill, old, poor, or burdened by the lengthy processing of their documents by immigration authorities, the United States provided the only source of health care. For some, Mexico may lessen the burden at the individual level, but it does not lessen the aggregate burden of providing highly priced care to the region's neediest. Health disparities will continue unless policies are enacted to expand health care accessibility in the region.