Arijit Nandi ¹, Sandro Galea ^2*, Gerald Lopez ³, Vijay Nandi ⁴, Stacey Strongarone ³, Danielle C. Ompad ⁴

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
² Department of Epidemiology, University of Michigan School of Public Health
³ Center for Community Problem Solving, New York University School of Law
⁴ Center for Urban Epidemiologic Studies, New York Academy of Medicine

^* To whom correspondence should be addressed. E-mail: sgalea{at}umich.edu.

	Abstract

Objectives. We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004.

Methods. We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care.

Results. In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care.

Conclusions. Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population.

Key Words: Epidemiology, Access to Care, Immigration, Hispanics/Latinos, Urban Health