86
2014. But undocumented persons are excluded from
the expansion and since Mexicans account for over
half of the undocumented population, theywill unfor-
tunatelycontinue tomakeupadisproportionate share
of the remaining uninsured population. Lacking health
insurance isa leadingbarrier toseekinghealthservices.
For those with health insurance, the type of
coverage and use of services has changed little over
the past ten years. Mexican and Central American
immigrants are still more likely to be covered by pu-
blic health programs in contrast with the non-His-
panic white population, themajority of whom enjoy
private health insurance coverage, which is thought
to offer more personalized and higher quality care.
While Mexican immigrants were less likely in 2013
to lack a regular sources of care than in 2004 (37%
and 42% respectively), these rates are still inequita-
ble since the rate is double that of immigrants from
other regions and triple the rateof non-Hispanicwhi-
tes andAfrican-Americans.
Despite experiencingmore barriers than others
inaccessinghealthcare,MexicanandCentralAmerican
immigrants have lower rates of some chronic diseases
compared to the African American and non-Hispanic
white populations. Hispanics (both immigrants and
native born) have lower rates of several of the most
frequent causes of death in the US, including cardio-
vascular disease and cancer. They also have the lon-
gest life expectancy (81.4 years) of all of the groups
studied. They are still disadvantaged however, in that
they have the second highest rate of diabetes –after
African Americans–which is a leading cause of death
andan importantpublichealth issue inboth theUnited
States and Mexico. Given the increasing risk factors
for diabetes in theMexicanoriginpopulation in theUS
addressing this issue is apriority.
Overall, thepatternofbirths for theMexican im-
migrant populationduring theperiodof 2004 through
2011 reflects the dynamics occurring in other popu-
lation groups of declining fertility, reflecting a con-
vergence towards the reproductive pattern of the US
and reflecting the declining fertility rates inMexico as
well. In the US, women inmost immigrant and racial/
ethnic groups are having fewer children, though the
decline in fertility is taking placemost rapidly among
Mexican immigrants. Mexican families continue to be
larger than others, but completed fertility is falling as
Mexicanwomenhave reduced their likelihoodof being
youngmothers and are starting their families at older
ages. Thismay be beneficial in contributing to overall
improved outcomes among infants. Mexican immi-
grantwomen are also following the trendof increasin-
gly starting familieswhile being unmarried, potentially
signalinga shift in family structure.
It is our hope that this report contributes to
framing the debate around equity in access to good
health.With thegrowthand spreadingof theMexican
origin population across the United States over the
past ten years, preserving their health and wellbeing
should be a top priority for policymakers. Legislation
like the
AffordableCareAct
isamajor step forward for
improving health care equity, however, an effortmust
bemade to findpolitically and socially acceptableme-
chanisms for alsoprotecting thehealthof undocumen-
ted immigrants andother excludedgroups.
Health is also related to social integration. Me-
chanisms that strengthen integration, such as acqui-
ring American citizenship, which enables immigrants
to exercise their rights and gain access to social and
economic benefits, should be expanded. In addition, a
more equitable balance in the labor market is needed
that offers opportunity for skill development and ad-
vancement into higher wage occupations would help
ease theconcentrationofMexicanandCentral Ameri-
can immigrants in low-wage sectors. Inaddition, policy
efforts to improve the minimum wage and establish
“livingwage” policies inmanycommunitiesprovide the
prospect for improved incomes, health, and quality of
life for themany low-wagedMexican immigrants.
Part of thewealth of the nation has historica-
lly been built on the social and economic contribu-
tion of immigrants. Health equity for immigrants is
not only a basic human right but also an important
element to sustain the social and economic benefits
of immigration for sending and receiving societies.
Mexican immigration to the US has been prominent
over the past decade, no less so than in decades be-
fore. It is the health of these immigrants that will
sustain the positive impact they have on the socie-
ties of origin and destination.
migration & health •
mexican immigrants in the us: a 10 year perspective
