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.