Odds of Access and Utilization of Health Care as a Function of Year and Citizenship Status or Interview Language Interactions, 2011 to 2015 National Health Interview Survey
| Outcome | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Insured | Delay in Care | Forgo Care | ED Use | Physician Visit | ||||||
| OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |
| Citizenship × time period* (n = 20,764) | ||||||||||
| US-born × after ACA | ||||||||||
| Naturalized × after ACA | 0.98 | 0.82–1.17 | 1.05 | 0.83–1.32 | 1.09 | 0.84–1.40 | 1.02 | 0.84–1.24 | 1.10 | 0.94–1.28 |
| Non–US citizen × after ACA | 1.03 | 0.81–1.30 | 0.80 | 0.62–1.03 | 0.83 | 0.62–1.12 | 0.94 | 0.76–1.16 | 1.15 | 0.96–1.36 |
| Interview language × time period† (n = 20,745) | ||||||||||
| English × after ACA | ||||||||||
| Spanish × after ACA | 1.02 | 0.87–1.20 | 0.97 | 0.79–1.19 | 0.92 | 0.74–1.14 | 0.96 | 0.76–1.22 | 1.17‡ | 1.01–1.37 |
↵* Models also control for race, interview language, age, sex, marital status, family income, education, US Census region, self-reported health status, chronic conditions, and functional limitations.
↵† Models also control for race, citizenship, age, sex, marital status, family income, education, US Census region, self-reported health status, chronic conditions, and functional limitations. These analyses excluded individuals who completed the National Health Interview Survey in a language other than English or Spanish.
↵‡ P < .05.
ACA, Patient Protection and Affordable Care Act; CI, confidence interval; ED, emergency department; OR, odds ratio.