Pediatrics
Volume 111, Issue 5 I, 2003, Pages 956-963

Health services use by children of migratory agricultural workers: Exploring the role of need for care (Article)

Weathers A.* , Minkovitz C. , O'Campo P. , Diener-West M.
  • a Dept. of Maternal and Child Health, University of North Carolina, Chapel Hill, NC, United States, Univ. North Carolina Sch. Pub. Hlth., 402A Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445, United States
  • b Dept. of Population Health Science, J. Hopkins Bloomberg Sch. Pub. Hlth., Baltimore, MD, United States
  • c Dept. of Population Health Science, J. Hopkins Bloomberg Sch. Pub. Hlth., Baltimore, MD, United States
  • d Department of Biostatistics, J. Hopkins Bloomberg Sch. Pub. Hlth., Baltimore, MD, United States

Abstract

Objective. For migrant children: 1) to assess the determinants of health services use among users and nonusers of health services; 2) to evaluate the association between health status and health services use, while controlling for potential confounders. Design. A cross-sectional household survey using multistage, partially random sampling to identify migrant families in eastern North Carolina. Participants. Adult caretakers of 1 randomly selected child under 13 years old. Results. Forty-four percent of children (N = 300) visited a doctor in the preceding 3 months. Those visiting a doctor disproportionately reported having less than very good health (29% vs 10%), insurance (46% vs 11%), interpreters (45% vs 27%), a family member receiving Special Supplemental Nutrition Program for Women, Infants, and Children (50% vs 16%), and a legal caretaker (30% vs 18%). Compared with those without a doctor visit, a larger proportion of children visiting a doctor were 6 years or younger in age (71% vs 35%), born in the United States (51% vs 15%), female (64% vs 45%), and had not moved in 6 or more months (19% vs 10%). Controlling for enabling resource and sociodemographic confounders, children with less than very good health were 2.4 times more likely than those in very good health to have visited a doctor (95% confidence interval [1.1-5.2]). Conclusions. Migrant children using health services are distinct from nonusers with regards to sociodemographic factors, enabling resources, and need for care. Health services use is associated with less than very good perceived health, despite resource barriers and sociodemographic disadvantages. More efforts are needed to improve access to health care for migrant children.

Author Keywords

Transients and migrants Health services accessibility health services needs and demand Health status residential mobility child Hispanic Americans Emigration and immigration

Index Keywords

Parents residential mobility immigrant agricultural worker human immigration North Carolina health service Agriculture priority journal health status ethnic group Logistic Models Family Characteristics Health Services Needs and Demand Cross-Sectional Studies migrant worker Humans Adolescent male female Infant Child, Preschool health services Article health care utilization Questionnaires adult major clinical study health care access child health care Transients and Migrants Health Services Accessibility Legal Guardians Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0038561171&doi=10.1542%2fpeds.111.5.956&partnerID=40&md5=5f5f2767c2d75929085cb24d721fc137

DOI: 10.1542/peds.111.5.956
ISSN: 00314005
Cited by: 15
Original Language: English