Racial and Ethnic Health Disparities in Los Angeles: The Role of Immigration Status and Neighborhoods

Marianne Bitler, Public Policy Institute of California (PPIC)

In this paper, we examine the determinants of health insurance coverage, health care utilization and access to a usual source of care, and health status. Using the Los Angeles Family and Neighborhood Study, we analyze outcomes for children and adults in Los Angeles County. We look at differences by race and ethnicity while controlling for other key determinants of health outcomes. We pay particular attention to differences in coverage, utilization, and health status by nativity (born in the U.S. or elsewhere), citizenship (naturalized or U.S.-born) and immigration status (among non-citizens, documented or undocumented). The ability to differentiate the undocumented from the documented is relatively novel. We find many of the SES gradients in health outcomes found by others. We find that documentation status (for adults) and parent's documentation status (for children) are important drivers of health differences across race and ethnicity. We find a much smaller role for neighborhood characteristics.