Health Care Access Among Hispanic Immigrants: ¿alguien Está Escuchando?[is Anybody Listening?]

Abstract

This systematic review identified 77 studies to examine patterns and determinants of health care access among Hispanic immigrants (HI) living in the U.S. In spite of major mental and physical care needs, HI and their families are at very high risk of not having access to health care compared with non-immigrant Hispanics and non-Hispanic whites. Noncitizenship status is a major barrier for accessing health care due to program ineligibility and fear of stigma and deportation. Low English proficiency is also an important barrier to health care. Culturally appropriate community outreach programs relying heavily on community health workers, also known as promotoras, have improved health care access and quality. Mexico shares the health care cost for HIs living in bordering states, calling for a binational dialogue. Mixed-methods research is needed to better understand: a) the net influence of acculturation on migrant health; b) the role of informal (e.g., family) vs. formal (e.g. promotoras) social support at facilitating health care access; c) issues related to ‘single’ male migrant farm workers; d) the “Hispanic mortality paradox”; e) traditional healing and medicine among HI. Comprehensive health and immigration reforms are needed to respect the human right that HIs have to gain access to health care.

Understanding social determinants of healthcare access from the perspective of Hispanic Latino immigrants in Louisville, Ky.

“…Similar to literature findings that identified community health workers or promotoras as facilitators to healthcare access, medical case managers facilitated access for participants in this study by encouraging healthcare access and utilization through the promotion of HIV screening, testing and education in the community, enhancing patient-provider communication and reducing cultural and language barriers (Pacheco et al, 2012;Perez-Escamilla et al, 2010). Several participants indicated that they received better medical attention, resources and social support for being HIV positive in the U.S. than they did in their home countries.…”

“…Analysis of data from the National Latino and Asian American Study (Mulvaney-Day, Alegria, & Sribney, 2007) revealed that strong social networks and social support serve as facilitators to overcoming illness-related stigma, healthcare avoidance and improved health outcomes. Perez-Escamilla et al (2010) identify the existence of variations among HLI subgroups in illness-related stigma. The study indicated that there is a combined influence of cultural differences, levels of education, and acculturation on healthcare access.…”

“…Studies also identified lack of cultural and language competency among healthcare providers and delivery of services as significant barriers to healthcare access among HLI (Asanin & Wilson, 2008;Castaneda et al, 2011;Rivers & Patino, 2006). As indicated in the literature, language barriers represented both individual and organizational factors as it was shown to be related to the LEP of HLI patients and the limited availability of interpreters within the healthcare system (Gurman & Becker, 2008;Harari et al, 2008;Perez-Escamilla, Garcia, & Song, 2010). Findings from a qualitative study on barriers to healthcare access among rural HLI indicated that language and communication were the main perceived barriers to access, as the LEP of participants influenced healthcare knowledge and health-seeking behaviors (Cristancho et al, 2008).…”

“…Language has been identified as significant barrier to healthcare access among HLI (Derose et al, 2007;Cristancho et al, 2008;Gurman & Becker, 2008;Harari et al, 2008;Perez-Escamilla et al, 2010).…”

Lessons from Hurricane Sandy: a Community Response in Brooklyn, New York

“…5 In Red Hook, 85 % of residents are Black or Latino; data indicate they are more likely to be exposed to social risk factors, increased barriers to health care, and compounded stressors than non-White residents. 28,29 In 2009, a health assessment survey for the residents of the Red Hook Houses was conducted to explore how sharing the 11231 zip code with an adjacent affluent neighborhood might mask health disparities. 6 Their findings highlight the following health disparities: 18 % of Red Hook Houses respondents had been diagnosed with diabetes versus 6 % in the 11231 zip code and 9 % in all of New York City.…”