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      Ventanillas de Salud: Defeating challenges in healthcare access for Mexican immigrants in the United States Translated title: Ventanillas de Salud: Desafíos en el acceso a servicios de salud de inmigrantes mexicanos en EE. UU.

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          Abstract

          Abstract The 2010 Affordable Care Act (ACA) improved access to healthcare in the United States. However, immigrants -especially those undocumented- still faced difficulties, which have increased during the Trump administration. In order to bring access to health services to its nationals, the Mexican government has implemented the Health Windows Program (Ventanillas de Salud, or VDS). The article reviews changes in the U.S. healthcare system from the ACA to date, and assesses the role of VDS. The methodology is qualitative, consisting of a literature review, interviews with community leaders and Mexican government officials, and questionnaires sent to four VDS: Arizona, Florida, Idaho and Texas. Results show that VDS provide reliable and affordable access to basic healthcare services, and detection of chronic and non-communicable diseases, especially within undocumented immigrants. Public policy recommendations are offered based on these findings. Limitations of the study include the data collected, which is non-representative of all VDS.

          Translated abstract

          Resumen: En 2010 la Affordable Care Act (ACA) brindó mayor acceso a la salud en Estados Unidos, pero los inmigrantes aún enfrentan dificultades, particularmente los indocumentados. Para brindar acceso a servicios de salud a sus connacionales, el gobierno mexicano creó el programa Ventanillas de Salud (VDS). El artículo analiza cambios en el sistema de salud de Estados Unidos a partir del ACA y el papel de las VDS. La metodología cualitativa incluye: revisión de literatura, entrevistas a líderes comunitarios y miembros del gobierno mexicano y cuestionarios enviados a cuatro VDS: Arizona, Florida, Idaho y Texas. Los resultados demuestran que las VDS proveen información confiable, acceso económico a servicios de salud, detección temprana de enfermedades crónicas y no transmisibles, especialmente para inmigrantes indocumentados. Se presentan recomendaciones de política pública basadas en evidencias. Las limitaciones radican en que los datos de las cuatro VDS no son representativos de todo el programa.

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          Most cited references 17

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          Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act

          Objective: To examine racial and ethnic disparities in health care access and utilization after the Affordable Care Act (ACA) health insurance mandate was fully implemented in 2014. Research Design: Using the 2011–2014 National Health Interview Survey, we examine changes in health care access and utilization for the nonelderly US adult population. Multivariate linear probability models are estimated to adjust for demographic and sociodemographic factors. Results: The implementation of the ACA (year indicator 2014) is associated with significant reductions in the probabilities of being uninsured (coef=−0.03, P<0.001), delaying any necessary care (coef=−0.03, P<0.001), forgoing any necessary care (coef=−0.02, P<0.001), and a significant increase in the probability of having any physician visits (coef=0.02, P<0.001), compared with the reference year 2011. Interaction terms between the 2014 year indicator and race/ethnicity demonstrate that uninsured rates decreased more substantially among non-Latino African Americans (African Americans) (coef=−0.04, P<0.001) and Latinos (coef=−0.03, P<0.001) compared with non-Latino whites (whites). Latinos were less likely than whites to delay (coef=−0.02, P<0.001) or forgo (coef=−0.02, P<0.001) any necessary care and were more likely to have physician visits (coef=0.03, P<0.005) in 2014. The association between year indicator of 2014 and the probability of having any emergency department visits is not significant. Conclusions: Health care access and insurance coverage are major factors that contributed to racial and ethnic disparities before the ACA implementation. Our results demonstrate that racial and ethnic disparities in access have been reduced significantly during the initial years of the ACA implementation that expanded access and mandated that individuals obtain health insurance.
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            Sistema de salud de México

            En este trabajo se describe el sistema mexicano de salud. En la primera parte se discuten las condiciones de salud de la población mexicana, con énfasis en los padecimientos emergentes que constituyen las principales causas de muerte: diabetes, enfermedades isquémicas del corazón, padecimientos cerebrovasculares y cáncer. En la segunda parte se describe la estructura básica del sistema: las instituciones que lo conforman, la población a la que cubre, los beneficios que reciben los afiliados de las distintas instituciones, las fuentes de financiamiento del sistema, los niveles de protección financiera alcanzados, los recursos físicos, materiales y humanos con los que cuenta y las principales tareas de rectoría que desarrollan la Secretaría de Salud y otros actores. También se describen los mecanismos de participación de los ciudadanos en la vigilancia y evaluación del desempeño del sistema y su nivel de satisfacción con los servicios recibidos. La tercera parte se dedica a discutir las innovaciones más recientes y su impacto en la operación del sistema. Destaca la discusión del recién creado Sistema de Protección Social en Salud y su brazo operativo, el Seguro Popular de Salud. El trabajo concluye con un análisis de los principales retos que enfrenta en el corto y mediano plazo el sistema mexicano de salud.
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              ESTAMOS TRAUMADOS: THE EFFECT OF ANTI-IMMIGRANT SENTIMENT AND POLICIES ON THE MENTAL HEALTH OF MEXICAN IMMIGRANT FAMILIES

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                Author and article information

                Journal
                estfro
                Estudios fronterizos
                Estud. front
                Universidad Autónoma de Baja California (Mexicali, Baja California, Mexico )
                0187-6961
                2395-9134
                2020
                : 21
                Affiliations
                California orgnameSecretaría de Relaciones Exteriores orgdiv1Servicio Exterior Mexicano orgdiv2Consulado General de México en San Francisco United States of America lgandoy@ 123456sre.gob.mx
                Mexico City Distrito Federal orgnameUniversidad Iberoamericana Ciudad de México orgdiv1Departamento de Estudios Internacionales Mexico valeria.valle@ 123456ibero.mx
                Article
                S0187-69612020000100101 S0187-6961(20)02100000101
                10.21670/ref.2001043

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 57, Pages: 0
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