Social Networks, Information and Health Care Utilization : Evidence from Undocumented Immigrants in Milan

This paper uses a novel dataset and research design to examine the effects of information networks on immigrants' access to health care. The dataset consists of an unusually large sample of undocumented immigrants and contains a direct indicator of information networks - whether an immigrant knew about health care opportunities from a strong social tie (relative or friend). This measure allows me to overcome some of the major identification issues that afflict most of the existing literature on network effects. The analysis focuses on the time spent in Italy before an immigrant first receives medical assistance. Estimates indicate that networks significantly foster health care utilization: after controlling for all available individual and ethnic characteristics, I find that relying on a strong social tie reduces the time to visit by 30%. I argue that this represents a lower bound estimate of the information effect of social contacts in the sample. Further investigation seems to confirm the quantitative importance of networks as an information device