Arturo Vargas Bustamante

This study examined racial and ethnic disparities in mental health service use, social support, and telemedicine access among U.S. adolescents between 2019 and 2022. Authors analyzed nationally representative data from the 2019-2022 National Health Interview Survey (NHIS) Sample Child Interview, focusing on adolescents aged 12 to 17. Multivariate logistic regression models with survey weights were used to assess disparities in outcomes by race and ethnicity. 

Findings: From 2019 to 2022, despite rising mental health needs, Black, Hispanic, and Asian adolescents were significantly less likely than white peers to take prescription medications, receive therapy, or receive both treatments. Hispanic and Asian adolescents were also 9 and 15 percentage points less likely, respectively, to report receiving community support, while Black and Asian adolescents were 8 and 6 percentage points less likely, respectively, to have had a virtual health care appointment. 

Access to mental health services, virtual care, and community support remains disproportionately limited for racial and ethnic minority adolescents, even as overall mental health needs have worsened across all groups during the COVID-19 pandemic. The underuse of virtual care and community support among Hispanic and Asian adolescents underscores the urgent need for culturally responsive strategies to promote accessible and personalized mental health care for all adolescents.

Authors examine differences in the utilization of low‐value care among Asian and Latino subpopulations compared to the white population. They analyzed data from a repeated cross‐sectional national survey. The study sample included a non‐Latino, white population and Asian and Latino subpopulation groups using data from the 2013–2021 Medical Expenditure Panel Survey.

Findings: Asian and Latino subpopulations used health care services less frequently than the white population. Although certain low‐value services were reported less among Asian and Latino subpopulations, there were no differences in almost 6 out of 12 services when compared to the white population. These patterns were notable among Asian subpopulations (Indians, Chinese, Filipinos, and other Asians). Additionally, Asian and Latino subpopulation groups had distinct patterns in the use of low‐value care. Compared to the white population, Asian subpopulation groups had lower utilization of low‐value medications including benzodiazepines for depression and opioids for back pain. Latino subpopulation groups had higher utilization of low‐value cervical cancer screening and lower utilization of magnetic resonance imaging/computed tomography for back pain than the white population.

Despite lower overall health care utilization, Asian and Latino subpopulations do not necessarily use the low‐value care examined in this study less than the white population. This suggests that lower overall health care utilization among Asian and Latino subpopulations may not solely be attributed to lower use of low‐value care.
 

On January 20, 2025, President Trump issued an executive order to end birthright citizenship in the U.S., a constitutional right guaranteed by the 14th Amendment. This policy brief discusses the health and social costs of ending birthright citizenship for millions of families in the United States. 

President Trump's executive order would deny citizenship to children born in the U.S. to:

• An undocumented immigrant mother and a father who is not a U.S citizen or green card holder OR
• A mother with a temporary status, such as on a student, work, or tourist visa, and a father who is not a U.S. citizen or green card holder.

Findings:

1. Anti-immigrant policies discourage families from using essential services, worsening health outcomes.
2. Restricting birthright citizenship will worsen barriers to prenatal care, driving up costs and harming infant health.
3. Immigrants contribute more to the U.S. health system than they receive in health care services.
4. Latino children would be disproportionately affected by changes to birthright citizenship.
5. Latino noncitizens, particularly the undocumented and temporary visa holders, would be the most affected racial and ethnic group if birthright citizenship ends.

The executive order ending birthright citizenship threatens the health and well-being of entire communities, including U.S. citizens. These policies generate fear and mistrust of government services and deter families from seeking necessary health care. Even if overturned, the order’s chilling effects will persist, worsening health outcomes, increasing health care costs, and heightening social and legal instability.

Policymakers and state governments must act swiftly to mitigate the harm by partnering with community-based organizations (CBOs) and trusted organizations to: 

1. Expand legal support: Increase legal orientation to help families navigate evolving immigration policies and protect their rights.
2. Combat misinformation: Disseminate clear, accessible information on the importance of preventive and prenatal care, ensuring immigrant and mixed-status families understand their health care options. 
3. Safeguard health care access: Strengthen protections that allow immigrant communities to seek essential health care services — especially prenatal and preventive services —  without fear of immigration enforcement or retaliation.
    

Summary: The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and U.S.-born Latinos and non-Latino whites. This study examined whether the paradox holds after accounting for health care access and utilization.

Researchers used 2019–2020 National Health Interview Survey data. The main predictors included population groups of foreign-born and U.S.-born Latinos (Mexican or non-Mexican) versus U.S.-born non-Latino whites. 

Findings: After adjusting for health care access, utilization, and predisposing and enabling factors, foreign-born Latinos, including those living in the United States ≥15 years, had lower predicted probabilities for most health outcomes than U.S.-born non-Latino whites, except overweight/obesity and diabetes. U.S.-born Latinos had higher predicted probabilities of overweight/obesity and diabetes and a lower predicted probability of depression than U.S.-born non-Latino whites.

In this national survey, the Latino health paradox was observed after adjusting for health care access and utilization and predisposing and enabling factors, suggesting that, although these are important factors for good health, they do not necessarily explain the paradox.

Read the Publications:

• Journal Article: Health Care Access and Utilization and the Latino Health Paradox