Patients Utilizing a Free Clinic: Physical and Mental Health, Health Literacy, and Social Support

Abstract

This cross sectional study assessed the physical and mental health, health literacy and social support of the uninsured utilizing a free clinic to develop intervention programs and research projects to improve the health of free clinic patients. Free clinics are nonprofit organizations that provide underserved and uninsured individuals access to a broad array of free or low cost healthcare services. English or Spanish speaking patients (N = 187) aged 18 years or older completed a self-administered survey. Physical, mental and oral health, health literacy, and social support were measured using standardized instruments. Eighty-two participants (45 US born and 37 non-US born) chose the English version of the survey (English speakers) while 105 participants (2 US born and 103 non-US born) chose the Spanish version (Spanish speakers). Overall, both the physical and mental health functioning of the participants was lower than that of the US general population. The participants reported being moderately depressed. US-born English speakers reported the poorest physical and mental health while Spanish speakers reported the best physical health and the lowest level of depression. A higher level of health literacy was associated with better physical health functioning, whereas reporting higher social support was associated with better mental health functioning and less severe depression. Because most free clinics have limited resources, developing services and programs that fit free clinics' circumstances are needed. Our study finding indicates that health literacy education, mental health services, and social support are key services needed by free clinic patients to achieve better health.

Development of a conceptual model of cancer caregiver health literacy

“…; Kamimura et al . ), later stage disease detection (Berkman et al . ) and, among older populations, increased mortality (Peterson et al .…”

“…Understanding and responding to health literacy issues is a key health promotion priority given the implications for individuals' self-management of their health, and for equity related to access to, and use of, healthcare services (Commonwealth of Australia 2009, Nielsen-Bohlman et al 2004, Kickbusch et al 2013, World Health Organization 2009). Inadequate health literacy has been associated with poorer health outcomes including increased rates of hospitalisation and emergency room presentations (Berkman et al 2011;Mitchell et al 2012), poorer medication adherence (Zhang et al 2014), poorer physical functioning and poorer quality of life (Apter et al 2013;Kamimura et al 2013), later stage disease detection (Berkman et al 2011) and, among older populations, increased mortality (Peterson et al 2011;Bostock & Steptoe 2012). Notably, these studies predominately assessed health literacy using measures that have been criticised for their focus on an individual's reading, comprehension and numeracy abilities, rather than the full breadth of concepts covered in modern definitions of health literacy (Mancuso 2009;Jordan et al 2010b;Buchbinder et al 2011a).…”

Perspectives of Health Care Services among Free Clinic Patients in the USA: A Qualitative Study

“…There are more than 1,000 free clinics in the US [5]. Free clinics patients are not only living in poverty but also often suffering from poor physical and mental health [6]. The existence of free clinics is imperative given the healthcare needs of individuals and families without health insurance coverage.…”

Uninsured free clinic patients’ experiences and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act

“…5 Free clinic patients suffer from a wide variety of medical conditions such as respiratory diseases, circulatory diseases, and mental disorders, 7 and tend to experience poor physical and mental health as well as low levels of health-related quality of life. 8,9 The purpose of this study is to investigate free clinic patients' experience and perceptions of healthcare services using an exploratory qualitative approach.…”

“…15 Informal resources (e.g., support from family or friends) are also important because stronger social support is associated with better mental health and less severe levels of depression among free clinic patients. 9 Some of the free clinic patients, who are not insured or who are under-insured, may be eligible to obtain insurance through the Patient Protection and Affordable Care Act (ACA). The purpose of the ACA is to guarantee health insurance to all American citizens.…”