Crossing the Border for Health Care: Access and Primary Care Characteristics for Young Children of Latino Farm Workers Along the US-Mexico Border

Seid, Michael; Castaneda, Donna; Mize, Ronald; Živković, Milutin; Varni, James W.

doi:10.1367/1539-4409(2003)003<0121:ctbfhc>2.0.co;2

Cited by 40 publications

(26 citation statements)

References 56 publications

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“…CONCLUSIONS -Health problems of border residents present unique challenges created by rapid population growth; substandard housing with lack of water, sewage systems, and paved roads; lack of health care access caused by a need to travel long distances to obtain services and lack of transportation; poverty that precludes paying for physician visits or recommended treatment; and individuals who speak only Spanish (23). Mexican Americans living on the U.S. side of the border obtain Ͼ50% of their health care in Mexico due to lower costs, greater accessibility, and perceptions of greater effectiveness (24). We designed an intervention by taking into account this sociocultural context (12).…”

Section: Baseline Resultsmentioning

confidence: 99%

Dosage Effects of Diabetes Self-Management Education for Mexican Americans

et al. 2005

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OBJECTIVE -The objective of this study was to compare two diabetes self-management interventions designed for Mexican Americans: "extended" (24 h of education, 28 h of support groups) and "compressed" (16 h of education, 6 h of support groups). Both interventions were culturally competent regarding language, diet, social emphasis, family participation, and incorporating cultural beliefs.RESEARCH DESIGN AND METHODS -We recruited 216 persons between 35 and 70 years of age diagnosed with type 2 diabetes Ն1 year. Intervention groups of eight participants and eight support persons were randomly assigned to the compressed or extended conditions. The interventions differed in total number of contact hours over the yearlong intervention period, with the major difference being the number of support group sessions held. The same information provided in the educational sessions of the extended intervention was compressed into fewer sessions, thus providing more information during each group meeting.RESULTS -The interventions were not statistically different in reducing HbA 1c ; however, both were effective. A "dosage effect" of attendance was detected with the largest HbA 1c reductions achieved by those who attended more of the extended intervention. For individuals who attended Ն50% of the intervention, baseline to 12-month HbA 1c change was Ϫ0.6 percentage points for the compressed group and Ϫ1.7 percentage points for the extended group.CONCLUSIONS -Both culturally competent diabetes self-management education interventions were effective in promoting improved metabolic control and diabetes knowledge. A dosage effect was evident; attending more sessions resulted in greater improvements in metabolic control. Diabetes Care 28:527-532, 2005T wenty-one percent of the U.S. population lives in states bordering Mexico, and Ͼ33% of these individuals live in medically underserved border communities characterized by extreme poverty, pollution, deprivation, poor health, and diminished quality of life (1). Sixty percent of Hispanics, predominantly Mexican Americans who have the lowest rates of insurance coverage of any group, live in border states (2), and diabetes and related morbidity and mortality rates are highest among these border residents (3-6).Traditional approaches to managing diabetes in the U.S. have been perceived by Mexican Americans, in some instances, as culturally insensitive and, thus, have been ineffective (7). We designed and tested nonpharmacological, culturally competent, community-based diabetes self-management interventions in Starr County, a Texas-Mexico border community in which 98% of the residents are Mexican American (8). Promoting attendance at lifestyle programs, i.e., ensuring an adequate "dosage" of the intervention, is a challenge, particularly in underserved groups who may lack transportation and who tend to live chaotic lives, with frequent financial, health, and personal crises. Mexican Americans value social networks, and women are expected to provide health care for family, relatives, and friend...

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Section: Baseline Resultsmentioning

confidence: 99%

Dosage Effects of Diabetes Self-Management Education for Mexican Americans

et al. 2005

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“…Furthermore, many farmworkers prefer to delay health care until they return to their home communities. For example, farmworker parents report that half of the health care provided to their children in the U.S.-Mexico border region was received in Mexico (93). Approximately half of those children with U.S. health insurance received health care in Mexico.…”

Section: Barriers To Farmworkers Accessing Health Servicesmentioning

confidence: 99%

“…However, they are fairly current. Two of these investigations (93,104,105) indicate that factors other than financial resources drive health care utilization for farmworker children. In a series of analyses focused on child health services among farmworker families living along the U.S.-Mexico border, the Parent's Perceptions of Primary Care Measure (P3C) has been developed and validated (94,95).…”

Section: Research On Farmworker Health Servicesmentioning

confidence: 99%

Delivery of Health Services to Migrant and Seasonal Farmworkers

Arcury¹,

Quandt

2007

Annu. Rev. Public Health

329

362

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Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.

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“…Another recent study, of largely US-born children in migrant Head Start centers (at the US-Mexico border), reported no association between insurance status and unmet health needs. 39 Characterization of those migrant children likely to forego needed care should inform program planning and outreach efforts.This analysis characterizes migrant children with unmet medical need and examines the independent associations of foreign birth and insurance status with unmet medical need while controlling for confounders. The Behavioral Model for Vulnerable Populations 40 guided covariate selection.…”

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confidence: 99%

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confidence: 99%

Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care

Weathers

Minkovitz²,

O’Campo³

et al. 2004

Pediatrics

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ABSTRACT. Objective. To assess the correlates of unmet need for medical care among migrant children.Design and Setting. A cross-sectional household survey used multistage sampling to identify migrant families in eastern North Carolina.Participants. Three hundred adult caretakers of 1 (per household) randomly selected child <13 years old.Results. Fifty-three percent of the children had an unmet medical need. The most common reasons for unmet medical need were lack of transportation (80%) and lack of knowledge of where to go for care (20%). Unmet medical need was associated inversely with less than very good health (odds ratio Conclusions. Medical-access barriers among migrant children are largely nonfinancial. Preschool-aged migrant children disproportionately experience unmet medical need. Decreasing forgone care among migrant children will likely require a combination of individual, health-system, and labor-policy modifications. Pediatrics 2004;113:e276 -e282. URL: http://www.pediatrics.org/cgi/ content/full/113/4/e276; transients, migrants, health services needs and demand, health-services accessibility, Hispanic Americans, child.[ABBREVIATIONS. OR, odds ratio; WIC, Women, Infants, and Children; CI, confidence interval. A ccess to care often is defined as the degree to which individuals are able to obtain needed health care. [1][2][3][4][5][6][7][8] The inability to obtain needed health care is used to indicate unmet needs for care. 9 A small and growing literature describes the prevalence and correlates of unmet need for health care among children. 9 -19 The prevalence of any unmet need for care among US children Ͻ18 years old is 7.3% 9 and varies by the type of care. For example, the proportion of children reported to experience an unmet need for medical care is 1.6%, whereas 5.3% of children are reported to experience unmet need for dental care. 9 Among all children, unmet need for care is consistently associated with poverty and a lack of insurance. 9 -12,14,15,17-19 Adjusted associations with unmet need for care among US children include 1) school age, 2) living in a single-parent household, 3) less than very good health status (including beddays or activity limitation), and 3) lack of a usual source of care. 9 Few studies examine the prevalence and correlates of unmet health needs among children categorized as ethnic/racial minorities. Although these studies reveal trends, several inconsistencies are evident. As compared with white (non-Latino) children, the prevalence of unmet health needs is generally higher among African American and Latino children. 9,20 -24 Moreover, Latino children have increased unadjusted odds of unmet need (odds ratio [OR]: 1.31; P Ͻ .01). 9 After multivariable control, the association between unmet need and ethnic/racial category became insignificant, 21,22,25 exhibited an inverse association, 9 or persisted among Latino females, as compared with males. 21 Similarly, the prevalence of unmet mental health needs is higher among African American, Latino, and Asian/Pacific Isla...

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Crossing the Border for Health Care: Access and Primary Care Characteristics for Young Children of Latino Farm Workers Along the US-Mexico Border

Cited by 40 publications

References 56 publications

Dosage Effects of Diabetes Self-Management Education for Mexican Americans

Dosage Effects of Diabetes Self-Management Education for Mexican Americans

Delivery of Health Services to Migrant and Seasonal Farmworkers

Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care

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