Primary Health Care Utilization by the Mexican Indigenous Population: The Role of the Seguro Popular in Socially Inequitable Contexts

Abstract

Objective: To analyze the relationship between primary health care utilization extended health insurance coverage under the Seguro Popular (SP) among Mexican indigenous people. Methodology: A cross sectional analysis was conducted using data from the Mexican National Nutrition Survey 2012 (n = 194,758). Quasi experimental matching methods nonlinear regression probit models were used to estimate the influence of SP on primary health care utilization. Results: 25% of the Mexican population reported having no health insurance coverage, while 59% of indigenous versus 35% of non indigenous reported having SP coverage. Health problems were reported by 13.9% of indigenous vs. 10.5% of non indigenous; of these, 52.8% 57.7% respectively, received primary health care (p,0.05). Economic barriers were the most frequent reasons for not using primary health care services. The probability of utilizing primary health care services was 11.5 percentage points higher (p,0.01) for indigenous SP affiliates in comparison with non indigenous, in similar socioeconomic conditions. Conclusion: Socioeconomic conditions, not ethnicity per se, determine whether people utilize primary health care services. Therefore, SP can be conceived as a public policy strategy which acts as a social buffer by enhancing health care utilization regardless of ethnicity. Further analysis is required to explore the potential gaps as a result of SP coverage among socially vulnerable groups.