Border States have the highest concentration of Mexican-origin people. The concentration of immigrants in the border has unique health and economic implications due to the vital role they have in US society, contributing both to the economy and diversity of the USA.Despite their important role, they disproportionately lack health insurance, and receive fewer health care services than US-born citizens. This lack of insurance puts a burden on the nation's economy, and their health status deteriorates as they become more prone to chronic health conditions, and their complications due to lack of primary medical attention.According to the US Census Bureau (2000), the Latino population increased by 57.9 percent since 1990. In 2000, Latinos comprise 12.5 percent of the overall population of the USA, and are the fastest growing minority group, among which the Mexican-origin population makes up about 66 percent.Border States have the highest concentration of Mexican-origin people within their overall Latino population because they contain significant points of entry. The largest Latino populations (more than one million) are concentrated in California, Texas, Illinois, Florida and Arizona. Of these, Arizona has the highest percentage of Latinos of Mexican-origin (82.2 percent).According to Burkholder and a report by the Kaiser Commission on Medicaid and the Uninsured (2000), Mexicans come to Arizona for work. Compared to other immigrants they tend to be younger, have lower education, lower wages, larger families, lower rates of citizenship, and have lived less time in the USA. Undocumented immigrants are a small yet important group within the immigrant population. Currently, there are an estimated 5 million undocumented immigrants in the USA, with half of them being from Mexico. The largest portion of the undocumented population is located in the Southwest. In 1998, it was estimated that about 20 percent of immigrants in the country were undocumented immigrants (Kaiser commission on Medicaid and the Uninsured, 2000)
Since the establishment of an Office of Minority Health, following the creation of a Task Force on Black and Minority Health in 1984, considerable funds have been devoted to further studies with the aim of reducing health disparities among racial and ethnic groups, however, those disparities still persist (Weinick and Krauss, 2000; Weinick et al., 2000).
Barriers to health care access
Sociocultural basis of health and disease
There is no question that income, educational attainment, and poverty levels are closely linked to health, health care access, and health insurance and that cultural values, beliefs, and attitudes influence help-seeking behaviors (Flores et al., 2002).
De la Torre and Estrada (2001) state that health does not exist in isolation from socioeconomic factors. In fact, socioeconomic status profoundly influences health status both positively and negatively, as has been shown in many studies (Sorlie et al., 1995; Kaplan and Keil, 1993; Feinstein, 1993). Several socioeconomic characteristics of the Mexican-origin population have harmful effects on both its general health care behaviors and its general health status. Low income, substandard housing, inadequate or unsanitary living facilities, limited formal education, ethnic segregation and discrimination, poor nutrition, and stress can and do affect the health of Mexican Americans in a number of ways (Sorlie et al., 1995; Kaplan and Keil, 1993; Feinstein, 1993).
Mexican Americans as a group have lower incomes, lower educational attainment, and higher poverty rates than non-Latino whites (Feinstein, 1993). Another problem is English language fluency. An extensive body of literature indicates that English skills and proficiency play an important role in the educational and economic success of Mexican-origin people (Feinstein, 1993). Language is also an important barrier to health care ac