Illegal immigrants and health care

The Times' Nov. 27 story on a study that found that illegal immigrants in Los Angeles County used fewer health services than U.S.-born Latinos garnered the same sort of response that comes for most stories about illegal immigration: Impassioned notes from people with viewpoints on all points of the political spectrum. Some 30 readers sent questions on the piece.

One of them, Kay Brown of South Pasadena, took The Times to task for seeking comment from a group she says is "anti-immigrant." Writes Brown: "I am offended that a totally anti-immigrant organization, Federation for American Immigration Reform, is being used without extensively qualifying this source. I hope the federation is not used just because they are easy to find. Reporters and editors are easily fooled into thinking the federation's point of view will help 'balance'  immigration issues."

Other readers questioned the study itself. Robert Hemedes of Los Angeles echoed others when he said the study was flawed because "it relies on a phone call survey where people will lie or undercount the number of times they use hospital services. The most accurate information can be collected from hospitals themselves. The collected results will most likely contradict what the phone survey missed."

Reporter Mary Engel, who covers health care, responds.

To answer concerns raised by the first reader, who asked why a certain group was cited in the story, Engel wrote in an e-mail:

Agree with it or not, the federation remains an influential lobbying group with an active legal arm, and it is a voice for many in the debate over immigration. Illegal immigration is a combustible topic, and I figured that a study that contradicted conventional wisdom, as this one did, would be especially controversial. For that reason, I wanted to be sure to give an anti-illegal-immigration group a chance to comment on the study.

For those readers who questioned the validity of the study, Engel says:

The study was published in the Archives of Internal Medicine, a well-known and peer-reviewed journal, which signals that its design and execution met the standards of other researchers. And the study drew on information collected by the California Health Interview Survey  http://www.chis.ucla.edu/, a collaboration of the UCLA Center for Health Policy Research and the state Department of Public Health that is widely used by legislators, health departments and others. 
   
Adds Engel, "There's a fascinating story in itself on how such surveys are done -- how they determine a random sample, how they take into account cell phones in telephone surveys and so on. Much of that is explained on the health survey website; I'll suggest to our Web folks that we try to link to such sites when possible. But in a daily story, with limited space, I focused on the study's findings while telegraphing as much information as I could about where the study was published and the size and source of the database."