No abstract

Objective-To assess how park characteristics and demographic factors are associated with park use.Methods-We studied a diverse sample of parks in a Southern California metropolitan area in 2006-2008 representing a variety of racial and ethnic communities of different socioeconomic strata. We surveyed 51 park directors, 4257 park users and local residents, and observed 30 parks. We explored relationships among the number of people observed, the number of park programs offered, number of organized activities observed, park size, existence of park advisory board, perceptions of safety, and population density and characteristics.Results-The strongest correlates of the number of people using the park were the park size and the number of organized activities observed. Neighborhood population density, neighborhood poverty levels, perceptions of park safety, and the presence of a park advisory board were not associated with park use.Conclusion-While perceptions of low safety have been considered a barrier to park use, perceptions of high safety do not appear to facilitate park use. Having events at the park, including sports competitions and other attractions, appears to be the strongest correlate of park use and community-level physical activity.

Inadequate access and poor quality care for immigrants could have serious consequences for their health and that of the overall U.S. population. The authors conducted a systematic search for post-1996, population-based studies of immigrants and health care. Of the 1,559 articles identified, 67 met study criteria of which 77% examined access, 27% quality, and 6% cost. Noncitizens and their children were less likely to have health insurance and a regular source of care and had lower use than the U.S. born. The foreign born or non-English speakers were less satisfied and reported lower ratings and more discrimination. Immigrants incurred lower costs than the U.S. born, except emergency department expenditures for immigrant children. Policy solutions are needed to improve health care for immigrants and their children. Research is needed to elucidate immigrants' nonfinancial barriers, receipt of specific processes of care, cost of care, and health care experiences in nontraditional U.S. destinations.

Many Latinos have limited English proficiency and this may negatively affect their use of health care services. To examine this, the authors interviewed 465 Spanish-speaking Latinos and 259 English speakers of various ethnicities who presented to a public hospital emergency department with non-urgent medical problems to assess previous physician visits, sociodemographic characteristics, and level of English proficiency. The proportion of patients who reported no physician visit during the 3 months before study enrollment was not related to English proficiency. However, among the 414 patients who saw a physician at least once, Latinos with fair and poor English proficiency reported approximately 22 percent fewer physician visits (p = 0.020 and p = 0.015, respectively) than non-Latinos whose native language was English, even after adjusting for other determinants of physician visits. The magnitude of the association between limited English proficiency and number of physician visits was similar to that for having poor health, no health insurance, or no regular source of care.