Predictors of healthcare utilization among Latinos and non-Latino whites : trauma, generation of U. S. residency, perceived health, and protective factors

This study contributes to understanding predictors of healthcare utilization among Latinos and non-Latino Whites in a low-income medical facility. Given the ever-increasing costs of healthcare, the patient’s need for effective services, and rapid increase in the Latino population, an accurate understanding of healthcare predictors is essential. In the present study 153 participants were included from Oregon, and completed a self-report survey. Predictor variables included: generation of U.S. residency, number of trauma types endorsed, Posttraumatic Stress Disorder (PTSD) symptoms (Primary Care-Posttraumatic Stress Disorder Screen, PC-PTSD), perceived health (Center For Disease Control Health Related Quality of Life – 4, CDC HRQoL-4), social support, educational attainment, self-esteem, and mental health utilization. Correlations were computed to determine which variables to include in the regression analysis for both Latinos and non-Latino Whites. Results revealed perceived health was related healthcare utilization and was a moderate predictor variable, accounting for 9.7% of the variance Predictors of Healthcare iv for non-Latino Whites. For Latinos, generation of U.S. residency, number of trauma types endorsed, and self-esteem were significant correlates with healthcare utilization and accounted for 14.9% of the variance. Non-Latino Whites tended to utilize services both within and outside Willamette Family Medical Center significantly more than Latinos. Compared to non-Latino Whites, Latinos had a lower level of PTSD symptomology and reported experiencing significantly fewer trauma types. Overall both groups experienced a higher rate of PTSD than was expected (Latinos = 25%, non-Latino Whites = 24%). Implications for healthcare and future research are discussed. Predictors of Healthcare v Table of Contents Approval Page ii Abstract iii List of Tables vii Chapter 1: Introduction 1 Latinos 3 Generation of U.S. Residency 4 Trauma 4 Perceived Health 6 Protective Factors 7 Social support 7 Educational attainment 8 Self-Esteem 9 Mental health utilization 9 Hypotheses 10 Chapter 2: Methods 11 Participants 11 Instruments 11 Procedure 13 Statistical Analysis. 13 Chapter 3: Results 14 Chapter 4: Discussion 20 Predictors of Healthcare vi Limitations 23 Suggestions for Future Research 23 Conclusion 24 References 26 Appendix A Informed Consent (English) 36 Appendix B Informed Consent (Spanish) 38 Appendix C Survey (English) 40 Appendix D Survey (Spanish) 44 Appendix E Curriculum Vita 47 Predictors of Healthcare vii List of Tables Table 1 Sample Descriptive Statistics 1 14 Table 2 Sample Descriptive Statistics 2 15 Table 3 Summary of Intercorrlations for Healthcare Utilization, PTSD Symptoms, Number of Trauma Types Endorsed, Perceived Health, Generations of U.S. Residency, Educational Attainment, Social Support, Self-Esteem, and Past or Present Mental Health Utilization by Ethnoracial Group 18 Table 4 Multiple Regression Testing Effects of Generation of U.S. Residency, Self-Esteem, and Number of Trauma Types Endorsed on Healthcare Utilization for Latinos (N = 76) 19 Table 5 Simple Regression Testing the Effect of Perceived Health on Healthcare Utilization for Non-Latino Whites (N = 77) 19 Predictors of Healthcare 1