Health care barriers and facilitators described by individuals with disabilities from underserved racial and ethnic groups

Background: Previous research has documented numerous barriers to health care for underserved racial and ethnic groups. More recently, barriers impacting individuals with disabilities have gained attention. However, little research has examined how disability, combined with race and ethnicity, relates to health care access and quality of health care. We qualitatively examined barriers and facilitators experienced by individuals with disabilities from underserved racial and ethnic groups seeking health care.

Methods: Working with national experts on race and ethnicity in the context of disability, we conducted nineteen focus groups in various U.S. locations. Groups targeted specific racial/ethnic and disability populations, including African-Americans, Asians, Latinos, and Native Americans with physical, sensory, or intellectual disabilities. We asked about positive and negative experiences with accessing health care, particularly as related to participants' race, ethnicity, and disability.

Results: Several themes emerged across groups. These included issues related to community resources such as transportation and support from friends or family; finances and insurance; aspects of health care sites; individual provider characteristics; discrimination and barriers related to one's race, ethnicity, language, and/or disability; other qualities of respondents themselves such as health knowledge and advocacy efforts; and emotions resulting from encountering barriers.

Conclusions: The findings provide unique insight into health care experiences of individuals belonging to multiple marginalized populations. Many themes mirrored barriers previously found either for underserved racial and ethnic groups or for people with disabilities. However, in this case, participants were impacted by compounded barriers.