Immigrants in the United States require less than half the health-care services than do native-born Americans, according to study findings published in the American Journal of Public Health.

Immigrant children get even lower levels of care, receiving 84 percent less than U.S.-born children, according to researchers at Harvard and Columbia universities and the Keck School of Medicine of the University of Southern California.

"Our study lays to rest the myth that expensive care for immigrants is responsible for our nation's high health costs," says Sarita Mohanty, M.D., M.P.H., assistant professor of medicine at the Keck School of Medicine, who led the study while at Harvard. "The truth is that immigrants get far less care than other Americans. Further restricting their eligibility for care would save little money and place many immigrants-particularly children-at grave risk. Already, many immigrant children fail to get regular checkups, and as a result more end up needing emergency care, or get no care at all."

The study is the first to analyze nationwide spending on immigrants' health care. Researchers analyzed data on 21,241 people in the Agency for Healthcare Research and Quality's 1998 Medical Expenditure Panel Survey, which collects detailed health-spending data on a representative cross-section of Americans. Researchers determined how much is spent per capita on health care among immigrants and non-immigrants by adjusting for differences between the two groups in age, income, health status and insurance status.

According to the study, immigrants comprised more than 10 percent of the U.S. population but accounted for less than 8 percent of total health spending and only 8 percent of government health spending.

Per capita health expenditures averaged $1,139 per immigrant, significantly less than the $2,564 expenditure for non-immigrants. And 30 percent of immigrants used no health care at all in the course of a year.

Most immigrants had health insurance coverage. Though uninsured immigrants used the least health care of any group-61 percent less than their uninsured counterparts who were born in the U.S.-even immigrants with insurance coverage used 52 percent less health care than insured non-immigrants.

Immigrant children received far less care in doctors' offices (71 percent less than non-immigrant children) and received 72 percent less prescription medications. However, their emergency room costs -$45 per child-were nearly three times greater than those for U.S.-born children, reflecting the high cost of foregoing routine care.

"Our data indicates that many immigrants are actually helping to subsidize care for the rest of us," says study co-author Steffie Woolhandler, M.D., associate professor of medicine at Harvard. "Immigrant families are paying taxes-including Medicare payroll taxes-and most pay health insurance premiums, but they're getting only half as much care as other families."

Study co-author Olveen Carrasquillo, M.D., M.P.H., of Columbia University's College of Physicians and Surgeons noted: "Latino immigrants had the lowest health expenditures -$962 per person-which is half those of US-born Latinos ($1,870) and less than one third those of U.S.-born whites ($3,117). The future economic success of the United States depends on a healthy immigrant workforce. Our findings suggest an urgent need for partnerships between health organizations and community groups to improve access to care, particularly for minority immigrants."

Sairta A. Mohanty, Steffie Woolhandler, David U. Himmelstein, Susmita Pati, Olveen Carrasquillo and David H. Bor, "Health Care Expenditures of Immigrants in the United States: A Nationally Representative Analysis," American Journal of Public Health. Vol 95, No. 8, August 2005, pp. 1-8.