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STATE VARIATIONS IN LINGUISTIC COMPETENCY POLICIES AND
THE EFFECTS ON IMMIGRANT ACCESS TO HEALTH SERVICES
by
Dennis Kao
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree of
DOCTOR OF PHILOSOPHY
(SOCIAL WORK)
August 2010
Copyright 2010 Dennis Kao
Object Description
| Title | State variations in linguistic competency policies and the effects on immigrant access to health services |
| Author | Kao, Dennis T. |
| Author email | denniska@usc.edu; denkao@sbcglobal.net |
| Degree | Doctor of Philosophy |
| Document type | Dissertation |
| Degree program | Social Work |
| School | School of Social Work |
| Date defended/completed | 2010-05-19 |
| Date submitted | 2010 |
| Restricted until | Restricted until 24 Jun. 2012. |
| Date published | 2012-06-24 |
| Advisor (committee chair) | Jansson, Bruce S. |
| Advisor (committee member) |
Chi, Iris Bola, John Myers, Dowell |
| Abstract | This study examined the effectiveness of state language policies in improving access to health services among the immigrant population. With high rates of immigration over the past several decades, states and their health systems face tremendous challenges in addressing the diverse language needs of their patients. States could play a key important role in addressing language barriers and under federal civil rights law, are required to ensure that their health systems are accessible to limited English proficient (LEP) persons, or those who speak English less than “very well.” However, with the lack of enforcement and oversight, a “patchwork” of state policies has emerged where there is considerable variation in how states address language barriers in the health setting. Whether these state polices are effective in reducing healthcare disparities has not been empirically tested.; This study attempted to empirically test the effectiveness of four types of state language policies: funding or reimbursement for language services; health interpreter competency requirements; hospital mandates; and managed care plan requirements. To do this, individual-level data were drawn from the 2002 National Survey of America’s Families (NSAF) and linked to state policy variables representing whether a state had a particular policy or not. Multilevel modeling was used to test whether the presence of each specific policy had a significant effect on access to health services among immigrants relative to U.S.-born persons. Separate analyses focused on the adult (aged 18 and over) and older adult (aged 50 and over) populations.; The results showed that certain state language policies—including funding mechanisms, hospital mandates, and managed care plan requirements—may have a positive effect on immigrant access to health services. The presence of funding mechanisms was marginally associated with the likelihood of having a usual source of care among immigrant adults and satisfaction with one’s health care among older immigrants. For both immigrant adults and older adults, hospital mandates marginally improved whether they had a usual source of care and were satisfied with their health care. Finally, managed care plan requirements improved the level of satisfaction with one’s health care for both immigrant adults and older adults—although for older immigrants, there was a large but nonsignificant effect. These findings suggest that state language policies can be used to address health access disparities affecting immigrant populations, in some cases, decreasing the immigrant/U.S.-born disparity by about four or more percentage points. |
| Keyword | immigrant populations; health care disparities; access to health services; limited English proficiency; language; state policies |
| Geographic subject (country) | USA |
| Coverage date | 2002 |
| Language | English |
| Part of collection | University of Southern California dissertations and theses |
| Publisher (of the original version) | University of Southern California |
| Place of publication (of the original version) | Los Angeles, California |
| Publisher (of the digital version) | University of Southern California. Libraries |
| Provenance | Electronically uploaded by the author |
| Type | texts |
| Legacy record ID | usctheses-m3152 |
| Rights | Kao, Dennis T. |
| Repository name | Libraries, University of Southern California |
| Repository address | Los Angeles, California |
| Repository email | http://www.usc.edu/isd/libraries/services/ask_a_librarian/email/ |
| Filename | etd-Kao-3866 |
| Archival file | uscthesesreloadpub_Volume17/etd-Kao-3866.pdf |
Description
| Title | Page 1 |
| Full text | STATE VARIATIONS IN LINGUISTIC COMPETENCY POLICIES AND THE EFFECTS ON IMMIGRANT ACCESS TO HEALTH SERVICES by Dennis Kao A Dissertation Presented to the FACULTY OF THE USC GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY (SOCIAL WORK) August 2010 Copyright 2010 Dennis Kao |
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