This study compares the unmet medical needs of foreign-born and U.S.-born adults. Both subjective and objective unmet medical needs are considered, and the roles of duration of U.S. residence, English language proficiency, and state-level destination type in explaining immigrants’ unmet need are assessed. Multivariate analyses of the 2007–2009 Medical Expenditure Panel Survey reveal that immigrants reported less subjective unmet need and equal or greater objective unmet need vis-à-vis natives. Among immigrants only, living less than 5 years in the U.S. and in a new or traditional, high-skill destination state versus a traditional, low-skill state is significantly associated with greater objective, but not subjective, unmet need. While this study reinforces the importance of stable health insurance and, to a lesser extent, income for gaining entry to the formal healthcare system for both immigrants and natives, it also highlights the need to identify factors that influence immigrants’ positive health-related perceptions, including characteristics of the healthcare system in origin countries.

In the face of continuing large immigrant streams, Hispanic and Asian immigrants’ human and social capital inequalities will heighten U.S. race/ethnic health and health care disparities. Using data from the 2004 and 2008 panels of the Survey of Income and Program Participation, this study assessed Hispanic-Asian immigrant disparity in access to health care, measured by perceived medical need and regular access to a physician. Logistic regression results indicated that Hispanics had lower perceived met medical need and were less likely to see a doctor regularly. These disparities were significantly attenuated by education and health insurance. Assimilation-related characteristics were significantly associated with a regular doctor visit and were not fully mediated by socioeconomic variables. Findings indicate the importance of education above and beyond insurance coverage for access to health care and suggest the potential for public health efforts to improve preventive care among immigrants.

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Although recent legal permanent residents and undocumented immigrants are generally barred from accessing public health insurance, some US states cover immigrant children through the Children’s Health Insurance Program (CHIP). In this study, we examine the contextual effect of US state health insurance eligibility policy, particularly with respect to immigrant children, on race/ethnic and nativity-based disparities in children’s routine health care. Utilizing our original data on state CHIP eligibility policies and child-level data from the Survey of Income and Program Participation, we find that a significant portion of between-state variation in children’s routine health care results from diversity in CHIP eligibility rules for poor and foreign-born children. Immigrant-specific disparities are reduced when states do not require five years of residency for CHIP participation.

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