Preventive Care

Immigrants use fewer preventive services than U.S. natives

Immigrants who come to the United States typically are in better health than U.S. natives. However, the longer they stay, the more their health assimilates to match that of U.S. natives. In a new study, Agency for Healthcare Research and Quality researchers Yuriy Pylypchuk, Ph.D., and Julie Hudson, Ph.D., compared immigrants' and U.S. natives' use of preventive care services to determine if this factor contributes to the decline in immigrants' health. When immigrants do not receive preventive services, they may be putting themselves at risk for having costly health conditions that might have been prevented if caught early, according to the authors.

Compared with immigrants, U.S. natives had more medical and dental visits, received more flu shots, and were screened more often for high cholesterol levels and cervical, breast, and prostate cancers. For example, 74 percent of natives had medical visits compared with 51 percent of immigrants, and 41 percent of natives had dental checkups compared with 22 percent of immigrants. Although immigrants' use of preventive services increases the longer they stay in the United States, their use never matches that of U.S. natives. Immigrants are more likely than natives to be uninsured when they arrive in the United States but tend to gain insurance the longer they stay in the country. However, even immigrants who obtained continuous private health coverage were less likely than U.S. natives to use preventive services. Immigrants may forego preventive care services because they do not understand that these services are covered by their insurance, they have other bills to pay, or must devote time and effort to adapt to a foreign environment, leaving less time to devote to preventive care.

The authors suggest that programs stressing the importance of preventive services may improve immigrants' behavior toward preventive care. The researchers used Medical Expenditure Panel Survey data from 2000 to 2004 for their study.

See "Immigrants and the use of preventive care in the United States," by Drs. Pylypchuk and Hudson in the August 2008 Health Economics. Reprints (AHRQ Publication No. 09-R025) are available from the AHRQ Publications Clearinghouse.

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