ABSTRACT
OBJECTIVE: Using large national databases, we investigated how living in the US-Mexico border region further limited access to healthcare among the non-elderly Hispanic adult population after controlling individual and county-level characteristics. METHODS: The 2008-2012 individual-level data of non-elderly Hispanic adults from the Behavioral Risk Factor Surveillance System (BRFSS) were merged with county-level data from Area Health Resources File (AHRF). Multivariate logistic analyses were performed to predict insurance status and access to doctors using residency in the US-Mexico border region as the key predictor, adjusting individual and county-level factors. RESULTS: Controlling only individual characteristic, Hispanics living in the US-Mexico border region had significantly lower odds of having health insurance (adjusted odds ratio [AOR] = 0.51; 95% confidence interval [CI], 0.49-0.54) and access to doctors (AOR = 0.69; 95% CI, 0.66-0.72). After including county-level measurements of healthcare system capacity and other local characteristics, the border region continued to be associated with lower likelihood of healthcare access. CONCLUSION: Hispanic residents in the U.S.-Mexico border had less access to healthcare than their inland counterparts. The findings highlight unique features in this region and support policies and initiatives to improve minority healthcare access, particularly among disadvantaged populations in this region.