Abstract
This study was designed to identify barriers and facilitators to enrollment in public health insurance programs in immigrant adolescents and young adults. Focus groups were held in English, Spanish and Mandarin to assess barriers and facilitators to insurance enrollment. Twenty-nine students participated in the focus groups, 11 Chinese speakers, 13 English speakers and 5 Spanish speakers. They were between the ages of 18 and 24. The major factors affecting failure to enroll were lack of correct information about enrollment process and qualifications, fear of being reported to immigration, and language barriers. In general, newly arrived students had less information and many more questions. Facilitators to enrollment included perceived need for health insurance, requiring help with medical care costs, and assistance with information gathering. To increase enrollment, we suggest school-based approaches to education and enrollment, increased presence of facilitated enrollers, and increased visibility of existing informational outlets.
Similar content being viewed by others
References
Larsen LJ. The foreign born population in the United States: 2003. Washington, DC: U.S. Census Bureau; 2004.
US Census Bureau. Profile of selected demographic and social characteristics for the foreign born population, 2000. Available at: http://www.census.gov/population/www/socdemo/foreign/STP-159-2000tl.html.
Park MJ, Paul Mulye T, Adams SH, et al. The health status of young adults in the United States. J Adolesc Health. 2006;39(3):305–17.
Harris KM, Gordon-Larsen P, Chantala K, et al. Longitudinal trends in race/ethnic disparities in leading health indicators from adolescence to young adulthood. Arch Pediatr Adolesc Med. 2006;160(1):74–81.
DeNavas-Walt C, Proctor BD, Smith JC. Poverty, income and health insurance: 2007. Washington, DC: United States Census Bureau; 2008.
Callahan ST, Hickson GB, Cooper WO. Health care access of hispanic young adults in the United States. J Adolesc Health. 2006;39(5):627–33.
Dey AN, Luca JW. Physical and mental health characteristics of US and foreign-born adults: United States, 1998–2003. Hyatssville: National Center for Health Statistics; 2006.
Weissman JS, Stern R, Fielding SL, et al. Delayed access to health care: risk factors, reasons, and consequences. Ann Intern Med. 1991;114(4):325–31.
Ortega AN, Fang H, Perez VH, et al. Health care access, use of services, and experiences among undocumented Mexicans and other Latinos. Arch Intern Med. 2007;167(21):2354–60.
Perry M, Kannel S. Medicaid and children, overcoming barriers to enrollment. Menlo Park: Henry J. Kaiser Family Foundation; 2000.
Park MJ, Paul Mulye T, Adams SH, et al. The health status of young adults in the United States. J Adolesc Health. 2006;39(3):305–17.
Flores G, Abreu M, Brown V, et al. How medicaid and the state children’s health insurance program can do a better job of insuring uninsured children: the perspectives of parents of uninsured latino children. Ambul Pediatr. 2005;5(6):332–40.
Fairbrother G, Stuber J, Dutton M, et al. An examination of enrollment of children in public health insurance in New York City through facilitated enrollment. J Urban Health. 2004;81(2):191–205.
Immigrant child health project: experiences of immigrant children in public health insurance programs: children’s defense fund. 2003.
Kincheloe J, Frates JE, Brown J. Determinants of children’s participation in California’s medicaid and SCHIP programs. Health Serv Res. 2007;847–66.
GmbH Scientific Software Development. Atlas.ti. In: GmbH Scientific Software Development, 5.5 ed. Berlin; 2008.
Wooldridge J, Hill I, Harrington M, et al. Interim evaluation report: congressionally mandated evaluation of the state children’s health insurance program. Washington, DC: Mathematica Policy Research, submitted to the Department of Health and Human Services; 2003.
Cai Y, Hong H, Shi R, et al. Long-term follow-up study on peer-led school-based HIV/AIDS prevention among youths in Shanghai. Int J STD AIDS. 2008;19(12):848–50.
Garfein RS, Golub ET, Greenberg AE, et al. A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users. AIDS. 2007;21(14):1923–32.
Rhodes SD, Foley KL, Zometa CS, et al. Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review. Am J Prev Med. 2007;33(5):418–27.
Acknowledgments
We would like to thank David Wei for his contributions to this study in recruitment of Mandarin speaking students, and transcription, and translation of Mandarin speaking focus group texts. Funding for this project was provided by a grant from the NYU School of Medicine.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hearst, A.A., Ramirez, J.M. & Gany, F.M. Barriers and Facilitators to Public Health Insurance Enrollment in Newly Arrived Immigrant Adolescents and Young Adults in New York State. J Immigrant Minority Health 12, 580–585 (2010). https://doi.org/10.1007/s10903-009-9308-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10903-009-9308-x