Usual sources, patterns of utilization, and foregone health care among Hispanic adolescents

Purpose: To describe and differentiate the usual sources of health care, patterns of utilization of services, and reasons for foregone health care among Hispanic adolescents by place of birth (U.S. mainland versus Puerto Rico or other country) and gender.

Methods: All subjects who identified themselves as Hispanic (n = 717) in a larger survey of 10,059 students in 7th (n = 3596), 9th (n = 3691), and 11th (n = 2772) grades in the state of Connecticut in 1996 were included in this secondary analysis. Data were analyzed using Pearson product-moment coefficients, Chi-squares, and logistic regression.

Results: The majority of usual sources of medical care services were community clinics or private doctors’ offices. Subjects born in Puerto Rico or countries other than the United States were more likely to use a doctor’s office. About 5% reported no usual source of care. Over 25% reported not going to a doctor or other health care provider when they thought they should (foregone care). There were significant gender differences in reasons given for foregone care. Feeling connected to others was a significant predictor of having had a physical examination and negatively associated with foregone care for girls. For boys, connectedness and use of alcohol were negative predictors of foregone care.

Conclusions: The majority of Hispanic youth in this sample report having a usual source of medical care and the source differs by place of birth. Adolescents who do not report high levels of connectedness are more likely to have foregone care. The most frequent explanation given for not having sought care was that subjects thought the problem would go away. Socialization about how to access and use health care services, as well as what to expect, is needed by Hispanic adolescents who may be at risk.