Safety Net Clinic Utilization for Sexual and Reproductive Health Services Among U.S.- and Foreign-Born Mexican-Origin Women.

Abstract

Objective: We describe utilization of sexual and reproductive health (SRH) services at safety net clinics (Title X and other publicly funded health care organizations) and private health care settings among U.S.- and foreign-born Mexican-origin women living in the United States. We also test whether nativity is associated with source of SRH care, adjusting for other factors.

Data sources and study setting: We pooled four waves of the National Survey of Family Growth (NSFG)-2011-2013, 2013-2015, 2015-2017, and 2017-2019-and included in our sample women who received SRH services in the previous 12 months.

Study design: We compared SRH service utilization and source (safety net clinics [Title X and non-Title X public] vs. private) between U.S.-born and foreign-born Mexican-origin women. We used multivariable regression to test whether nativity was associated with source of care.

Principal findings: Our sample included n = 1,923 (N = 4,446,577) Mexican-origin women aged 15-44, 42.9% of whom were foreign born. Foreign-born women of Mexican origin were more likely to be uninsured (43.8% vs. 13.4% among the U.S. born) and had a significantly higher adjusted probability of using safety net clinics to access preventive SRH services compared with Mexican-American women (42.2%; 95% CI [35.5, 48.9%] vs. 27.6%; 95% CI [22.9, 32.2%]).

Conclusions: Safety net clinics such as Title X and other publicly funded health care organizations play an important role in access to preventive SRH care among Mexican-origin women living in the United States, especially for foreign-born women.