Valdez et al., 1993; Wyn et al., 1993). Latinos, African Americans, and Asians also have fewer physician visits than non-Latino whites, for general medical care, acute and chronic conditions, and preventive services (Aday et al., 1993; Wyn et al., 1993; Mendoza, 1994; Lieu et al., 1993; Vega and Amaro, 1994). However, few studies have examined the effects of immigration and citizenship status on health insurance coverage and access to health care, despite its central importance in understanding ethnicity, particularly for Latinos and Asians.

This paper examines health insurance coverage and access to health care services among first-generation immigrant children and U.S. citizen or nonimmigrant children in immigrant families, compared to children in nonimmigrant families. The effects of immigration and citizenship status and ethnicity on uninsurance and on access to physician visits are examined. The extent to which immigrant children and U.S. citizen children in immigrant families have higher uninsured rates and/or less access to health care services has important policy and research implications.

Recent public policy changes may substantially reduce access for immigrant children and U.S. citizen children with noncitizen parents. In 1996 Congress dramatically reduced the entitlement of noncitizen immigrants to a broad range of federal public assistance programs, including Medicaid. Much of the debate has centered on undocumented and legal immigrant adults, with little attention to the potential impact of sweeping reforms on children—despite the fact that many of the changes taking place disproportionately affect children, particularly immigrant children, and may reduce their access to health care services. These policy changes have increased the importance of understanding factors that affect health insurance coverage and access to health care services among children in immigrant families.

In this study two population-based surveys, the March 1996 Current Population Survey (CPS) and the 1994 National Health

Front Matter (R1-R12)

1 Children of Immigrants: Health, Adjustment, and Public Assistance (1-18)

2 Socioeconomic and Demographic Risk Factors and Resources Among Children in Immigrant and Native-Born Families: 1910, 1960, and 1990 (19-125)

3 Access to Health Insurace and Health Care for Children in Immigrant Families (126-186)

The Health and Nutritional Status of Immigrant Hispanic Children: Analyses of the Hispanic Health and Nutrition Examination Survey (187-243)

5 Immigration and Infant Health: Birth Outcomes of Immigrant and Native-Born Women (244-285)

6 The Health Status and Risk Behaviors of Adolescents in Immigrant Families (286-347)

7 Educational Profile of 3- to 8-Year-Old Children and Immigrants (348-409)

8 Psychological Well-Being and Educational Achievement Among Immigrant Youth (410-477)

9 Passages to Adulthood: The Adaptation on Children of Immigrants in Southern California (478-545)

10 Receipt of Public Assistance by Mexican American and Cuban American Children in Native and Immigrant Families (546-583)

11 Receipt of Public Assistance by Immigrant Children and Their Families: Evidence from the Survey of Income and Program Participation (584-619)

12 Children in Immigrant and Nonimmigrant Farmworker Families: Findings from the National Agricultural Workers Survey (620-658)

Other Reports from the Board on Children, Youth, and Families (659-660)