Language Access and Health Equity: Changes under the Affordable Care Act

Applebaum, Bethany; Robbins, Sarah M.

doi:10.1353/hpu.2016.0064

Cited by 9 publications

(3 citation statements)

References 9 publications

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“…CHCs are one of the only options for undocumented immigrants, two-thirds of which are estimated to be without health insurance [22]. Though the ACA has increased funding for CHCs and increased access to emergency Medicaid and language services, it is unclear if immigrants in Cincinnati are benefiting from the ACA, and cuts to Medicaid Disproportionate Share Hospital (DSH) payments may further reduce their access to care [11, 22–23]. …”

Section: Introductionmentioning

confidence: 99%

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

Topmiller

Zhen‐Duan

Jacquez

et al. 2016

J. Racial and Ethnic Health Disparities

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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.

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Section: Introductionmentioning

confidence: 99%

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

Topmiller

Zhen‐Duan

Jacquez

et al. 2016

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

show abstract

“…Refugees and resettlement employees describe challenges at all points of acute care access due to language barriers and a lack of appropriate interpretation services. Revisions to the Affordable Care Act in 2016 mandated that healthcare facilities must offer qualified interpreters to limited English proficient (LEP) patients16 and the 2010 Joint Commission standards also require qualified interpreter services in hospital settings 17. However, patients with LEP have worse clinical outcomes and receive a lower quality of care 18.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Accessing Acute Care for Newly Arrived Refugees

Zeidan

Khatri

Munyikwa

et al. 2019

WestJEM

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Over the past decade, the number of refugees arriving in the United States (U.S.) has increased dramatically. Refugees arrive with unmet health needs and may face barriers when seeking care. However, little is known about how refugees perceive and access care when acutely ill. The goal of this study was to understand barriers to access of acute care by newly arrived refugees, and identify potential improvements from refugees and resettlement agencies. Methods: This was an in-depth, qualitative interview study of refugees and employees from refugee resettlement and post-resettlement agencies in a city in the Northeast U.S. Interviews were audiotaped, transcribed, and coded independently by two investigators. Interviews were conducted until thematic saturation was reached. We analyzed transcripts using a modified grounded theory approach. Results: Interviews were completed with 16 refugees and 12 employees from refugee resettlement/post-resettlement agencies. Participants reported several barriers to accessing acute care including challenges understanding the U.S. healthcare system, difficulty scheduling timely outpatient acute care visits, significant language barriers in all acute care settings, and confusion over the intricacies of health insurance. The novelty and complexity of the U.S. healthcare system drives refugees to resettlement agencies for assistance. Resettlement agency employees express concern with directing refugees to appropriate levels of care and report challenges obtaining timely access to sick visits. While receiving emergency department (ED) care, refugees experience communication barriers due to limitations in consistent interpretation services. Conclusion: Refugees face multiple barriers when accessing acute care. Interventions in the ED, outpatient settings, and in resettlement agencies, have the potential to reduce barriers to care. Examples could include interpretation services that allow for clinic phone scheduling and easier access to interpreter services within the ED. Additionally, extending the Refugee Medical Assistance program may limit gaps in insurance coverage and avoid insurance-related barriers to seeking care. [

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“…A clientela multilinguística está em alto risco para iniquidades em saúde. Por exemplo, nos EUA, os imigrantes que não falam fluentemente inglês têm recebido menos cuidados preventivos, menos acesso à saúde e cobertura, levando a resultados de saúde menos favoráveis (14) . Em Toronto, os serviços de saúde para uma população multilinguística tiveram o português como idioma de destaque, representando 22% dos participantes.…”

Section: Introductionunclassified

Toronto’s Portuguese-speaking community potential for creating a social support-networks for breast cancer

Maheu¹,

Zanchetta²,

Gebremariam³

et al. 2020

Rev. Eletr. Enferm.

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An ethnographic study explored ideas about the possibility of creating social support networks for breast cancer within the Portuguese-speaking community in Toronto (Canada). Nineteen men and women from Angolan, Brazilian and Portuguese communities informed about a social support network with a focus on enabling versus challenging conditions for its construction. The fundamental components in creating social support networks were: the demystification of breast cancer and its prevention, emphasis on health education, mobilizing volunteers and direct social support to women living with breast cancer. The potential enabling factors were the participation of older women as social leaders, and the utilization of schools and religious institutions. Perceived barriers were: breast cancer believed to be women’s disease, lack of knowledge about its cure/ rehabilitation, as well as a limited sensitivity to cancer. Social support networks should consider the communities’ diverse cultural and tangible needs, as well as more informal social support services.

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Language Access and Health Equity: Changes under the Affordable Care Act

Cited by 9 publications

References 9 publications

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

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

Barriers to Accessing Acute Care for Newly Arrived Refugees

Toronto’s Portuguese-speaking community potential for creating a social support-networks for breast cancer

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