Place Matters in Non-Traditional Migration Areas: Exploring Barriers to Healthcare for Latino Immigrants by Region, Neighborhood, and Community Health Center

Abstract

This paper identifies differences in adult Latino immigrant barriers to healthcare in the Cincinnati area in Hamilton County, OH on three levels: by region, by neighborhood, and by community health center. Secondary data analysis was performed on 439 surveys. Respondents were aggregated by the geographic regions and neighborhoods where they live and by two community health centers where they receive care. Outcome measures included pragmatic and skill barrier indices adapted from the Barriers to Care Questionnaire (BCQ); the pragmatics index consists logistical barriers, including transportation and cost; the skills index is made up of items related to navigating the healthcare system, including communicating with physicians and completing paperwork. The results indicate that immigrant Latinos living in western Cincinnati and northern Hamilton County face significantly higher pragmatic barriers to care, while Latino immigrants going to a community health center in western Cincinnati have significantly fewer pragmatic and skill barriers than immigrants utilizing a nearby community health center. Because healthcare options for undocumented immigrants do not improve with the Affordable Care Act, community health centers will continue to serve as their primary source of care. This is particularly true in non-traditional migration areas, where immigrants tend to be isolated and lack resources. Efforts to improve access to healthcare for immigrant Latinos require place-based approaches that allow for targeted resources to improve care in these locations. This study helps to fill that need by identifying variation in barriers to care on multiple levels and offering strategies to alleviate these barriers.

Health disparities among adults with voice problems in the United States

“…We observed that minorities, low‐income adults, and those with public or no health insurance were more likely to delay care due to lack of transportation compared to white adults even when adjusted for other possible confounding factors. This is similar to well‐established findings throughout the medical literature that minorities, low‐income individuals, or those with inadequate health insurance face higher barriers to healthcare and encounter issues related to transportation to appointments and missing work . For example, geographic analysis of women with breast cancer in Atlanta revealed a significantly longer commute via public transportation to the nearest radiation therapy facility for black women compared with white women .…”

“…For example, geographic analysis of women with breast cancer in Atlanta revealed a significantly longer commute via public transportation to the nearest radiation therapy facility for black women compared with white women . Low‐income individuals and minorities are more likely to live in neighborhoods that are isolated from healthcare facilities and lack sufficient healthcare resources . Inadequate health insurance is also a factor in geographically limiting where care for voice problems can be received, which likely leads to having to travel farther to obtain voice services.…”

“…This is similar to well-established findings throughout the medical literature that minorities, low-income individuals, or those with inadequate health insurance face higher barriers to healthcare and encounter issues related to transportation to appointments and missing work. 17,23,24 For example, geographic analysis of women with breast cancer in Atlanta revealed a significantly longer commute via public transportation to the nearest radiation therapy facility for black women compared with white women. 24 Low-income individuals and minorities are more likely to live in neighborhoods that are isolated from healthcare facilities and lack sufficient healthcare resources.…”

“…24 Low-income individuals and minorities are more likely to live in neighborhoods that are isolated from healthcare facilities and lack sufficient healthcare resources. 23 Inadequate health insurance is also a factor in geographically limiting where care for voice problems can be received, which likely leads to having to travel farther to obtain voice services. The racial and socioeconomic disparities in access to medical care for those with voice problems may contribute to the predominantly white and wealthy patient population that is treated for vocal disorders.…”

Partnering with insiders: A review of peer models across community-engaged research, education and social care

“…Utilising a peer model also has benefits and advantages for the peer communities including actionable project findings/results applicable to the community, improved health and social services, enhanced understanding of community needs and priorities and increased awareness of important issues at community level, social change and justice (Baynes et al., ; Boise et al., ; Brown et al., ; Calhoun, ; Chen et al., ; Cortez et al., ; Dill, ; Downey et al., ; Gabriel et al., ). Furthermore, working with peers in a peer model can improve the quality of research, education and interventions in terms of recruitment, contextually and culturally relevant questionnaires, methods and techniques, data collection and screening, interpretation of results and translation and dissemination of findings (Chang et al., ; Horowitz, Brenner, Lachapelle, Amara, & Arniella, ; Hull et al., ; Martin et al., ; McElfish et al., ; Minkler et al., ; Olsson et al., ; Sharma et al., ; Topmiller, Zhen‐Duan, Jacquez, & Vaughn, ).…”